|Description:||From a left lateral perspective, the nose of this patient exhibited cutaneous changes that after a complete differential diagnostic study proved to be lepromatous leprosy. The skin surface had been transformed into reddish-brown nodules atop the left ala, and it appears that the disease process included the left nare and nasal vestibule. Ruled out in the diagnosis was scleroma, syphilis, and malignancy in general. Leprosy is caused by the bacterium Mycobacterium leprae.|
A chronic infectious disease, leprosy usually affects the skin and peripheral nerves, but has a wide range of possible clinical manifestations. Patients are classified as having paucibacillary or multibacillary Hansen's disease. Paucibacillary Hansen's disease is milder and characterized by one or more hypopigmented skin macules. Multibacillary Hansen's disease is associated with symmetric skin lesions, nodules, plaques, thickened dermis, and frequent involvement of the nasal mucosa resulting in nasal congestion and epistaxis.