"Leprosy awareness among physicians is needed," Krahenbuhl said.
Dr. David Scollard, chief of the HRSA National Hansen's Disease Program clinical branch in Baton Rouge, agreed: "Although this disease is not common, it's also not gone," he said.
Antibiotics can kill the bacteria, but Krahenbuhl and Scollard stressed that treatment should begin as soon as possible to minimize nerve damage.
Scollard cites the case of a 30-something man who migrated from the Marshall Islands to Utah and didn't realize his skin lesions were serious. When he finally sought help, the lesions were advanced. He's been on treatment for nearly two years and will need another few years more, Scollard said.
"There is no epidemic," Scollard emphasizds. "There is no cause for great alarm." But awareness would increase the chances of catching and treating leprosy cases early, he said.
"Ultimately it is a disease of the peripheral nerves," Krahenbuhl said. "The earlier you treat, the more likely you are to arrest and block it."
The horrible stigma of contagious leprosy persists, Krahenbuhl and Scollard said, with its legacy of ostracized "leper colonies." The reality is that those who catch the disease almost always have been exposed for a prolonged period of time to a family member with it. In fact, once patients have had a few doses of medicine, he said, they are no longer infectious.
More physician awareness about the disease is definitely needed, agreed Dr. Samuel Moschella, a dermatologist at Lahey Clinic in Boston. He was not involved in the panel discussion but is an expert on the topic.
Skin lesions with numbness should make any physician think about the possibility of a leprosy diagnosis, he said, especially in patients from India, Brazil, Burma, Nepal o
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