Hansen's disease: a cause of lymphadenopathy in endemic areas
Satti, M.B.; al-Mohaya, S.; Omer, A.S.
Tropical and Geographical Medicine 41(1): 80-84
1989
ISSN/ISBN: 0041-3232 PMID: 2763351 Document Number: 331635
This is a report of "unusual presentations of leprosy". Two male patients presented at a general hospital in Saudi Arabia with fever and other signs of ENL reaction (lepra reaction type 2) which was difficult to diagnose as the skin showed no lesions suggestive of leprosy. Both patients had a generalized lymphadenopathy, and gland biopsies showed changes of lepromatous leprosy.[The worldwide stigma of leprosy is such that it is not unusual for patients under treatment to withhold this fact from doctors. They consult for conditions they consider to be unrelated, and if they have been taking dapsone for 6-12 months their leprosy nodules have disappeared. My own experience (see Proceedings of the Royal Society of Medicine, 1969, 62, 161) suggests that both patients were taking dapsone when seen by the authors, as the first patient had been treated with "tablets" after the biopsy of a skin nodule at another hospital a year previously, and the second patient had a family history of leprosy and was either helping himself to the family supply of tablets or had been prescribed treatment at the family's leprosy clinic.]W.H. Jopling.