01435nas a2200145   4500000000100000008004100001100001100042700001600053700001700069700001400086700001600100245010700116520105200223022001401275       2015                            d1 aLeon K1 aSalinas J L1 aMcDonald R W1 aSheth A N1 aFairley J K00aComplex Type 2 Reactions in Three Patients with Hansen's Disease from a Southern United States Clinic.3 a<p>In non-endemic countries, leprosy, or Hansen's disease (HD), remains rare and is often underrecognized. Consequently, the literature is currently lacking in clinical descriptions of leprosy complications in the United States. Immune-mediated inflammatory states known as reactions are common complications of HD. Type 1 reactions are typical of borderline cases and occur in 30% of patients and present as swelling and inflammation of existing skin lesions, neuritis, and nerve dysfunction. Type 2 reactions are systemic events that occur at the lepromatous end of the disease spectrum, and typical symptoms include fever, arthralgias, neuritis, and classic painful erythematous skin nodules known as erythema nodosum leprosum. We report three patients with lepromatous leprosy seen at a U.S. HD clinic with complicated type 2 reactions. The differences in presentations and clinical courses highlight the complexity of the disease and the need for increased awareness of unique manifestations of lepromatous leprosy in non-endemic areas.</p>
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