Leprosy in Denmark 1980–2010: a review of 15 cases

Abstract

BackgroundLeprosy, caused by Mycobacterium leprae, is a chronic and progressive granulomatous disease affecting mainly the skin and the peripheral nervous system. If left unrecognized, the infection can lead to permanent nerve damage and disability. The clinical presentation depends on the immune response of the patient and can result in a wide spectrum of symptoms. Leprosy is a rare encounter in Scandinavia but remains endemic in some parts of the world, with some areas reporting an increasing incidence. We performed a retrospective record review of leprosy cases in Denmark from 1980 to 2010 with the purpose of presenting the most common geographical, demographic and clinical findings and to discuss the diagnostic and therapeutic challenges of patients with leprosy.Case presentationIn total 15 cases were reviewed. The majority (87 %) of leprosy patients in Denmark were born in South- and Southeast Asia, and were presumed to have contracted the infection in their countries of origin. Patients were predominately young males (mean age: 28.6 years). Anaesthetic skin lesion with or without nerve enlargement were the most common clinical presentations (73 %). Immunological leprosy reactions were seen in 40 % of the cases. Diagnoses were based on clinical findings and skin biopsies. Treatment length varied but all patients received multidrug regimens.ConclusionLeprosy should be kept in mind when encountering patients with suspicious skin lesions originating from leprosy endemic areas or with history of travel or work in the tropics. Due to the long incubation period with symptoms presenting long after immigration or return, clinicians often do not have the diagnosis in mind. The wide spectrum of symptoms and immunological reactions further complicates the diagnostic process. Treatment of leprosy and the complicated immunological reactions, which frequently accompanies the infection, should be performed in collaboration with a specialist.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1768-6) contains supplementary material, which is available to authorized users.

Leprosy in Refugees and Migrants in Italy and a Literature Review of Cases Reported in Europe between 2009 and 2018

“…Nineteen papers published between 2009 and 2018 were included in the review, accounting for 280 patients reported by five nationwide reports [ 7 , 8 , 9 , 22 , 23 ] ( Table 2 ), 14 case reports [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ], and three case series described by single centers [ 7 , 38 , 39 ] ( Table 3 ).…”

“…In Europe, leprosy incidence declined after the late medieval period with no cases reported to the WHO during the period 2009–2014, followed by an increased detection trend from 18 cases during 2015 to 50 cases at the end of 2018 [ 6 ], prevalently in foreign-born patients [ 7 , 8 , 9 ].…”

Seek and Find! PCR analyses of skin infections in West-European travelers returning from abroad with an eschar

“…One Mycobacterium leprae infection was acquired in the Comoros. A French study conducted from 2009 to 2013 reported that the Comoros were the main focus of Mycobacterium leprae infections diagnosed in France [24], while in a study conducted in Madrid, from 1989 to 2015, most cases were migrants from South America [25] and in a Danish study conducted from 1980 to 2010, most cases were migrants from South-East Asia [26]. In our study, one Bartonella henselae case was diagnosed in a patient returning from Morocco, a disease rarely described in Morocco [27][28][29][30], while fleas have been shown to be positive for Bartonella henselae in this country [31].…”

An Update on the Epidemiology, Diagnosis and Treatment of Leprosy

“…Hypoesthesia skin lesion is the most important diagnostic factor because it is not expected in another skin disease other than leprosy. After evaluation of skin lesions, peripheral nerves should be palpated for thickening, and nerve examination of lesions and distal extremities should be performed [69]. Conjunctiva and corneal examination should also be made.…”

“…1000 bacillus in every area) with the amount of bacteria in each microscope area. Patients with BI scores lower than 2 are considered as PB, whereas BI scores above 2 are considered MB [69].…”