Signs and Symptoms of Hansen's Disease

Hansen’s disease, otherwise known as leprosy, is caused by an infection from the bacteria Mycobacterium leprae. Signs and symptoms often emerge years after initial infection. The disease affects the skin, upper airway and peripheral nerves. Knowing the signs and symptoms of Hansen’s disease is crucial to receiving an early diagnosis. Treating the disease in the early stages prevents potentially serious nerve damage and subsequent disability.

Numbness

• According to the New Zealand Dermatological Society, one of the most common early signs of Hansen’s disease is numbness, beginning in the fingertips and toes. Generally, the first sensation which is lost is the perception of temperature. Afterward, sensation slowly dwindles, beginning with light pressure, pain/aching and ultimately firm pressure.

Skin Lesions

• One of the chief symptoms of leprosy is the presence of lesions on the skin. Initially, the lesions may present as pale spots on the skin prior to becoming a clear lesion. The type of lesion is largely determined based upon the category of the disease: tuberculoid, borderline tuberculoid, borderline borderline, borderline lepromatous or lepromatous. Tuberculoid leprosy is a mild form of the disease. The borderline categories are characterized by an increasing amount of lesions and disease advancement. Lepromatous leprosy is notable for advanced symptoms, such as neurological damage, and is the most severe form of the disease. Lesions may be raised, flat, light or darkly colored and become dry with hair loss at the site. Lesion types include single red patches with defined and elevated borders, numerous irregularly-shaped patches, lesions of varying sizes and shapes, and areas which appear similar to inverted saucers.

Advanced Symptoms

• Without treatment, Hansen’s disease may cause significant physical alterations. The skin over the forehead and on the arms, legs and ear lobes becomes thickened, eyelashes and eyebrows lose hair and the shape of the nose may collapse or become distorted. Sensitivity to light, glaucoma and blindness can result when the disease involves the eyes. Men may show signs of gynecomastia (abnormally enlarged breasts) or experience sterility due to shriveled testicles. The patient’s voice may become hoarse if the larynx is involved, and infections of the internal organs can result in enlarged lymph nodes or an enlarged liver.

Laboratory Confirmation

• According to the National Hansen’s Disease Program, there are no blood or skin tests which can confirm a diagnosis of Hansen’s disease. Doctors must perform a skin biopsy to confirm the presence of the disease. Skin biopsies may reveal inflammatory cells known as granulomas. Laboratories may also use a special stain to view acid-fast bacilli, a type of bacteria which are shaped like a rod and belong to the Mycobacterium family. The number of acid-fast bacilli present varies in accordance with the type of leprosy.