C. McKay M. Gupta , R. Hannaford , S. Kossard , M. Tan
Leprosy is a rare, notiﬁ able disease in Australia. In 1999 the World Health Organisation established the Global Alliance to Eliminate Leprosy (GAEL) which aimed to eliminate the disease by 2005. Elimination was deﬁ ned as reducing the prevalence to one case per 10,000. Australia met this goal in 2002. Most cases of leprosy in Australia today occur in patients who have lived in, or returned from endemic areas. In 2008 there were 11 cases reported in total. We discuss 3 cases that presented in Sydney, NSW, in 2011. Firstly, a 33 year old Nepalese man living in Australia for 6 years with erythemaous truncal plaques and associated peripheral neuropathy consistent with borderline tuberculoid downgrading to borderline lepromatous leprosy.
Secondly a 27 year old Sri Lankan man with widespread prominent plaques and symmetrical nerve involvement consistent with borderline lepromatous leprosy. The third case is a 55 year old well-travelled Caucasian Australian man who presented with two small circular scaly plaques on his back. Biopsy was consistent with tuberculoid leprosy. Leprosy has an incubation period of many years and typically diagnosis can be delayed. The disease can present with a wide spectrum of clinical appearances which stem from varying host immune responses to the pathogen, Mycobacterium leprae.
This small case series illustrates the varying clinical picture of leprosy, and reminds the dermatologist to always consider this disease in the differential diagnosis of erythematous or hypopigmented plaques with or without associated sensory/motor nerve disturbance.