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Q J Med 2001; 94: 207-212
© 2001 Association of Physicians

The diagnosis of leprosy is delayed in the United Kingdom

D.N.J. Lockwood and A.J.C. Reid

From the Hospital for Tropical Diseases, London, UK

Received 29 December 2000 and in revised form 8 February 2001

Diagnostic delay in leprosy can have serious neurological consequences for the patient. We studied the presentation of leprosy patients, focusing on delays in diagnosis, in a retrospective case-note review of 28 patients referred to The Hospital for Tropical Diseases during 1995–1998. The median ages at onset of symptoms and at diagnosis were 25.1 years (range 9–77.7) and 30.1 years (range 9–78.3), respectively. The median time from symptom onset to diagnosis was 1.8 years (0.2–15.2). Prior to referral to a leprologist, patients had seen a dermatologist (20), neurologist (9), orthopaedic surgeon (5) and rheumatologist (2). Delay in diagnosis occurred in 82% of cases. Misdiagnoses as dermatological and neurological conditions were important causes of delay, and 68% of patients had nerve damage resulting in disability. Leprosy can be difficult to diagnose outside endemic areas. Increased awareness amongst general practitioners and hospital specialists would lead to more rapid diagnosis, thus minimizing damage and disability.

Address correspondence to Dr D.N.J. Lockwood, Hospital for Tropical Diseases, Mortimer Market, Capper Street, London WC1E 6AU. e-mail: diana.lockwood{at}lshtm.ac.uk


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