Leprosy: uncommon presentations

The uniqueness of the clinical-dermatologic elements of leprosy recommends that control programs worldwide should diagnose the disease based on the so-called main clinical signs: cutaneous-neurological lesions with sensitivity-motor alterations without obligatoriness of a bacilloscopic or histopathologic examination. The recognition of initial signs and symptoms of Hansen disease sometimes presents difficulties for its diagnosis, especially considering the relevance of an early diagnosis and the present guidelines for performance of decentralized treatment of the patient in the basic health-care network. The clinical cases illustrating this article were selected because of the degree of difficulty found in the confirmation of their diagnoses that required a histopathologic and/or bacilloscopic examination.