Leprosy should be considered in the differential diagnosis when evaluating both foreign- and U.S.-born patients with granulomatous dermatitis and peripheral neuropathy, despite the condition’s rarity in the North America. That is according to a report published online ahead of print (Mayo Clinic Proceedings Feb. 20, 2019). The study examined local case studies of leprosy by reviewing the risk factors and demographic information of affected patients.
A total of nine leprosy patients who received care at the Mayo Clinic from 1994 to 2017 were identified using an electronic health record database. Investigators collected demographic information on the patients which included: age, gender, travel history, skin biopsy results, and country of origin. Seven of the patients were male and two were female, and were between 15 to 63 years of age. All of the patients had leprosy lesions on their skin involving their head, neck, trunk, as well as their upper and lower extremities. Six of the patients had emigrated from foreign countries, specifically: Mexico, Indonesia, Micronesia, and Guam. Researchers also reported that many of the patients had neurological problems, such as a reduced sense of touch.
Extensive travel while being immunosuppressed and a Micronesian lineage were common factors observed in the leprosy patients.
“Immunosuppressed people travelling to countries where the disease is prevalent in high rates are at highest risk, as are people planning on being in close contact with others infected for long periods of time,” said lead study author Dr. Spencer Bezalel, dermatology resident at the Mayo Clinic in Tampa, Fla., in a press release.
In most modern-day cases, people who are diagnosed with the condition are immunosuppressed transplant patients or those who are taking immunosuppressive medications for other medical conditions. Living in or travelling to regions where the rates of leprosy are high is also another factor that puts patients at risk.
Although cases of leprosy are rare in North America, the results of this study emphasize that the condition cannot be considered completely eradicated in certain circumstances.
“Leprosy is not highly contagious or easily spread, and most people have immunity against the disease,” says Dr. Bezalel.
Antibiotic therapy for patients with leprosy as well as vigilance and education from the medical community on behalf of immunosuppressed people or those who travel considerably are adequate measures to prevent the devastation caused by leprosy.