Leprosy physical examination

Leprosy Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

Paucibacillary Hansen's disease is milder and characterized by one or more hypopigmented skin macules. Multibacillary Hansen's disease is associated with symmetric skin lesions, nodules, plaques, thickened dermis, and frequent involvement of the nasal mucosa resulting in nasal congestion and epistaxis.

Physical Examination

Appearance of the Patient

• Multiple bruises and/or burns from trauma, generally involuntarily self-inflicted.

Vitals

• A fever may be present.

Skin

• Painless cuts, wounds and burns are often present, predominantly on the hands, arms, legs and feet.
• Hypopigmented and/or erythematous skin patches are often present.

Cutaneous leprosy lesions on a patient's thigh.

Head

• Lumps often present, predominantly on the face and earlobes.

Extremities

• Weakness of the hands and feet may be present.

Neurologic

• Sensory loss is often present, predominantly on skin lesions and on the territories located after enlarged peripheral nerves.
• Paresthesias are often present, predominantly in the hands and feet.
• Tender and/or enlarged peripheral nerves are often present.

References

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