Commentary: “Primary Neural Leprosy mimicking rheumatological disorders”

Given the persistent incidence of leprosy, with around 30 thousand annual cases over the past ten years, the interest of new clinical specialties on the disease is promising, even though the subject is not unknown among leprologists¹.

The early diagnosis of leprosy is the cornerstone of the strategy to reduce its prevalence, temporarily increasing it, but consistently decreasing it in the medium term. Each new case spurs the search for the sources of patient infection, which could be themselves or a multibacillary family member, and the chain of transmission is interrupted upon treatment.

Another important aspect in the case presented by Freitas et al.² is the demonstration that an event without skin lesions may present itself as multibacillary in the nerve and, therefore, be a source of contagion, according to other rare publications on the subject.³

In complex diagnosis, i.e. those involving unusual procedures such as nerve biopsy, it is pertinent to describe every step taken to reach the diagnosis, with the patient as a possible source of contagion, and begin the search for those with whom he/she had contact, who are possible new cases and other sources of contagion.

REFERENCES

• ¹
  Pernambuco R, Pernambuco JCA, Ura S, Fleury RN. Hanseníase Virchoviana e artrite reumatóide: sobreposição ou mimetismo? Hansen Int. 2002;27(1):29-34.
• ²
  Freitas RCS, Pereira CAZ, Muri NT, Franzon VAZ, Fatuch CAC. Primary Neural Leprosy mimicking rheumatological disorders. Rev Assoc Med Bras. 2019;65(6):767-770.
• ³
  Barreto JA, Carvalho CV, Cury Filho M, Garbino JA, Nogueira MES, Soares CT. Hanseníase multibacilar com baciloscopia dos esfregaços negativa: a importância de se avaliar todos os critérios antes de se definir a forma clínica. Hansen Int. 2007;32(1):75-9.

Publication Dates

• Publication in this collection
  22 July 2019
• Date of issue
  June 2019