Greater auricular nerve thickening with varied skin manifestations in Hansen's patients

Hansen's disease commonly presents with light coloured numb patches with a peripheral nerve thickening. Sometimes the nerve thickening may be the only clue to the diagnosis of the disease. Hence the peripheral nerve examination holds an important place in the diagnosis of Hansen's disease. Many a times an isolated nerve thickening may be ignored or misdiagnosed. A series of 3 cases with greater auricular nerve thickening with varied manifestations has been presented in this article. The first case had a skin lesion on the face which was mistaken for dermatophyte infection whose thickened Greater Auricular nerve was ignored. The second case had a isolated nerve thickening was misdiagnosed and managed as a case of external jugular vein thrombosis with heparin and hypolipidemic drugs. The third case had a thickened greater auricular nerve which he had ignored but later reported for treatment once his skin lesion had developed. Health professionals responsible for diagnosis of leprosy in peripheral settings as well as specialists working in referral institutions need to be aware of such varied manifestations of Hansen's Disease.