Thursday, November 17, 2011


This patient notes that the lesion by his eye is numb. He also has hypopigmented lesions on his nose and testicles. All of these lesions have decreased sensation. On exam, you also note that he has no eyebrows. In fact, advanced forms of this disease can be associated with saddle nose deformities and hoarseness. On examination, some nerves appear enlarged and tender such as the greater auricular nerve, common peroneal nerve, and ulnar nerve.

Challenge: Thinking of the geographic distribution of the abnormalities, what's your diagnosis?

Image shown under Fair Use.


sid said...

Hansen's disease

Craig Chen said...

you're right!

This is leprosy, caused by Mycobacterium leprae, which grows best at 27-33C and thus affects cooler areas of the body.

Source: UpToDate.