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SPECIAL ARTICLE
Year : 2018  |  Volume : 6  |  Issue : 1  |  Page : 157-170

Revisiting hansen's disease: Recognizing the many neurodermatologic faces and its diagnostic challenges


1 Department of Neurology, Yenepoya Medical College, Mangalore, Karnataka, India
2 Department of Dermatology, Yenepoya Medical College, Mangalore, Karnataka, India

Correspondence Address:
Prof. Dr. Bhaskara P Shelley
Department of Neurology, Yenepoya Medical College, Yenepoya (Deemed to be) University, Mangalore - 575 018, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/amhs.amhs_57_18

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Hansen's disease (HD) looms still as a public health problem. Conventional wisdom and teaching largely view HD as a predominantly dermatologic disorder with much emphasis in the dermatology postgraduate curriculum. This review attempts to reorient this view and reemphasize that HD has primarily neurologic underpinnings since Mycobacterium leprae is an intracellular neurotropic bacterium. The main thrust of this article would, therefore, be a neurologist's perspective of HD. The cutaneous manifestations of HD are the sequelae of the neurobiology of M. leprae, its selective predilection to human Schwann cells, neurovascular bundle and its localization in the intracutaneous nerve plexus of the skin. We discuss the nuances of HD as a “great imitator,” the many faces of its neurodermatologic clinical presentation, the neurologic basis of HD clinical examination, and its diagnostic and therapeutic challenges.


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