Section : Skin Conditions

Hansen’s disease (Leprosy)

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

What is Hansen’s disease?

  • It is an infection caused by a bacteria called Mycobacterium Leprae.

How is it transmitted?

  • This is still incompletely understood but it would be airborne.
  • It is not transmitted during birth and even prolonged contact does not guarantee transmission.

How is it diagnosed?

  • Examination of a skin biopsy is the most reliable and based on clinical suspicion.
  • Lepromin tests are helpful to classify the type of leprosy but not to confirm the diagnosis.

What does it look like on the skin?

  • The disease is classified according to the immunity of the infected person:
  1. Tuberculoid (Paucibacillary)(maintained host immunity): lesions tend to be depigmented, few in number with an impaired sensation.
Tuberculoid Leprosy (Hansen's Disease)

Tuberculoid Leprosy (Hansen

  1. Lepromatous (Multibacillary)(depressed host immunity): lesions tend to be more voluminous, many in number and the face can be infiltrated (leonine facies).
Lepromatous Leprosy (Hansen's Disease) with Leonine Facies

Lepromatous Leprosy (Hansen

  1. Borderline: lesions less specific in between the Tuberculoid and Borderline types.
Borderline Leprosy (Hansen's disease)

Borderline Leprosy (Hansen

  • Immunological reactions: sometimes the lesions do not contain the bacilli and are due to the immunity developed by the infected person: erythema nodosum leprosum,  reversion reactions (increased inflammation because of effective treatment, stress, pregnancy…)

Are other organs affected?

  • The nervous system and eyes are the most commonly affected:
  1. Facial palsy
  2. Blindness
  3. Claw-hands
  4. Foot-drop
  • Lower limbs are sometimes amputated due to prolonged bone resorption (osteomyelitis) and skin cancers developing on prolonged ulcers.

How is it treated?

  • Treatment regimens vary from country to country.
  • Antituberculous drugs, Dapsone and other antibiotics are used. Treatment must be continued for several months or years depending on the type of leprosy.
  • Steroids and other anti-inflammatory drugs are used in immunological reactions.


Dr Christophe HSU – dermatologist. Geneva, Switzerland

National Skin Centre. Singapore

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Category : hansen's disease - Modifie le 08.6.2010Category : lepra - Modifie le 08.6.2010Category : lèpre - Modifie le 08.6.2010Category : leprosy - Modifie le 08.6.2010Category : maladie de Hansen - Modifie le 08.6.2010