http://www.residentandstaff.com/issues/articles/2005-11_03.asp Leprosy was well recognized in antiquity and was often associated with social stigma. In 1873, Dr G. Hansen first identified Mycobacterium leprae as the cause for this condition, which was then named Hansen's disease. Not until the 20th century was specific treatment developed. Leprosy remains endemic to certain areas in the world, especially tropical and subtropical zones. Overall prevalence has decreased, but the reported incidence of leprosy has remained steady, even in the United States. In light of the significant morbidity associated with the disease, physicians must remain vigilant for its signs and symptoms even in developed countries, especially with increasing travel to and from endemic areas.

A 28-year-old Hispanic male presented with a rash which started at his forehead two years earlier and slowly progressed over his body. Nodular and pruritic, the rash was accompanied by thinning hair and numbness below his knees. Various topical and oral treatments only temporarily relieved his symptoms. Examination revealed nasal congestion, nodular skin lesions most prominently deforming his face, and decreased sensation at the lower limbs. Skin biopsy yielded the definitive diagnosis of leprosy. Leprosy (Hansen?s Disease), caused by Mycobacterium leprae, was well-recognized among antiquity and often associated with social stigma. Not until the 20th century was the disease more well-understood and specific treatment developed. Leprosy remains endemic to specific areas worldwide. While overall prevalence has decreased, reported incidence remains steady, including in the United States. Health practitioners in developed countries must remain vigilant of leprosy, especially with increasing travel from endemic areas and the significant morbidity of the disease.