Leprosy, annular lesions.

LEPROSY

Early (indeterminate) leprosy most commonly presents as an area of skin numbness or a poorly defined hypopigmented patch. Lesions are often found on the face, extensor surfaces of the limbs, buttocks, and trunk.

Leprosy in the United States

• Each year, about 150-200 cases of leprosy are diagnosed in the US. Most of those are from imigrants.
  
• However, some states are endemic, e.g. Florida.
• Cases from Hawaii, Texas, California, Louisiana, New York and Florida made up 72% of cases.
  
• Contact with the armadillo is a risk factor for development of leprosy and cases have been reported in the US in Texas and Florida.
  
• About 25% of household contacts will ultimately develop leprosy.
• Lepromatous leprosy is the most contagious type.
• Incubation period is 2-30 years.
• The first reported case in Bay County Florida was in a man who had hunted armadillos for 30 years.
• The organism best grows at 27-33 C so likes cooler body sites like ears, nose, testes etc.

A young man presented to a clinic in Southern California with these infiltrated edematous plaques, mostly on the trunk.

RegionalDerm

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