Characterization of Rheumatic Manifestations in Hansen's Disease: A Standardized Approach among Patients from Puerto...

Area of Science:

• Rheumatology
• Infectious Diseases
• Dermatology

Background:

• Rheumatic manifestations are a common but understudied feature of Hansen's disease (HD), often overlooked compared to skin and nerve involvement.
• Existing research lacks systematic characterization and appropriate controls for evaluating rheumatic symptoms in HD patients.

Purpose of the Study:

• To systematically evaluate and characterize the spectrum of rheumatic manifestations in patients with Hansen's disease.
• To compare the prevalence of rheumatic features in HD patients versus a control group without HD.

Main Methods:

• A cross-sectional study involving 23 patients with HD and 23 age/sex-matched controls from Puerto Rico.
• Standardized clinical evaluations and examinations for rheumatic features, including demographic data, comorbidities, and treatments.
• Bivariate statistical analyses to compare HD patients and controls.

Main Results:

• 87% of HD patients presented with rheumatic manifestations, primarily arthralgia (73.9%) and arthritis (69.6%).
• HD patients showed significantly higher rates of arthritis (especially in small hand joints), tendinopathy, dactylitis, and swollen hand/foot syndrome compared to controls.
• These rheumatic symptoms were strongly associated with leprosy reactions and multibacillary HD, persisting post-treatment in many cases.

Conclusions:

• Rheumatic manifestations are highly prevalent in Hansen's disease and occur significantly more often than in the general population.
• A considerable number of patients experience persistent rheumatic symptoms despite completing multidrug therapy (MDT), highlighting a need for ongoing management.
• Early recognition and management of these potentially debilitating rheumatic manifestations are crucial for improving functional outcomes in HD patients.