01691nas a2200229   4500000000100000008004100001260001200042653001100054653002300065653002500088653001200113100001500125700002600140700001400166700001400180245003800194856008500232300001200317490000600329520111200335022001401447       2019                            d  c10/201910aCanada10aHansen’s disease10aMycobacterium leprae10aleprosy1 aPallares C1 aBourassa-Blanchette S1 aFonseca K1 aVaughan S00aLeprosy: Challenges in diagnosis.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9603024/pdf/jammi.2019.05.24.01.pdf  a187-1890 v43 a<p>Leprosy (Hansen's disease) is caused by&nbsp;Mycobacterium leprae. It affects the skin and peripheral nerves. Incidence and prevalence are underestimated due to challenges in diagnosis and unfamiliarity with the disease in Canada. Untreated disease can lead to permanent nerve damage with subsequent loss of function. We present a case of Hansen's disease with delay in diagnosis and treatment. A 31-year-old female recent immigrant from the Philippines presented with a 2-year history of a palpable erythematous rash on her face and arms. She had a diagnosis of cryoglobulinemic vasculitis associated with her chronic hepatitis B. A course of topical corticosteroids did not alleviate symptoms. The rash had a waxing and waning pattern that was felt to mirror her antiviral therapy. Although hepatitis B cryoglobulinemia has been reported in the remote literature, further studies have failed to illustrate that it is a significant cause of cryoglobulinemia. Retrospective analysis of the case identified that anchoring to the initial diagnosis was the reason for delay in diagnosis and treatment.</p>
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