[Leprosy differential diagnosis in 1996]

Due to a decrease in the prevalence of leprosy, discussion of its differential diagnosis assumes increasing importance. Research on the early diagnosis of leprosy, before the onset of nervous lesions, the appearance (or improved definition) of certain diseases and the expansion of intercontinental migration are some of the factors which have induced changes in the conditions of leprosy diagnosis. The most frequent and most sensitive differential diagnosis of leprosy have been reviewed: hypochromic diseases, tropical infections diseases, systemic diseases, deforming diseases, cutaneous lymphoma and AIDS. The difficulties posed by forms of leprosy revealed by reactional manifestations are stressed. Today, as in previous times, positive and differential diagnosis of leprosy is based on the following simple practices: study of lesion, sensitivity, bacilloscopy and the examination of the peripheral nervous system. Cutaneous histology is the complementary reference examination.