Leprosy Mailing List – December 30th, 2012
Ref.: To what extent are the peripheral nerve lesions that may complicate leprosy given space in neurology curricula?
From: G Warren, Sydney, Australia
Dear Dr Noto,
I have recently seen some suggestions for the ILA Congress programme and note the accent on nerve involvement, which is very good. Lots of doctors do not know how to examine nerves and what the significance there is of a little hardening in a superficial nerve. I have become very concerned that the current younger clinicians never think of leprosy. Very few are actually taught much practically about leprosy and very few even think of leprosy in the differential diagnosis in new patients with mild skin infiltration or even those with neuritis symptoms as mentioned in the email. I include herewith which Jean Watson sent to you last year [Leprosy Mailing List – January 8th, 2011]:
<< "Ref.: To what extent are the peripheral nerve lesions that may complicate leprosy given space in neurology curricula?
I refer to Prof. Ryan message (LML (Dec. 31st, 2010). To what extent are the facial and peripheral nerve lesions that may complicate leprosy given space in neurology curricula? These are usually not the first signs of leprosy but, in my recent Far East experience, even signs of such nerve lesions do not consistently trigger thoughts of leprosy in neurology departments during differential diagnosis. Hence even further delays in leprosy diagnosis and treatment. One patient was operated on by tendon transfer in a major city hospital after ulnar paralysis but before leprosy was identified as the cause of the nerve lesion.
Jean Watson" >>
Please can I ask that consideration be given to discussing methods of teaching the younger generations so that they will think of leprosy as a possibility? In many endemic areas or areas that used to be highly endemic, there are Medical schools where leprosy is barely taught - some I suspect it is just left out. Yes W.H.O. may talk about elimination but we know that there are still lots of new cases and if we can get them diagnosed early and treated properly we can prevent permanent deformity or disability. What the doctors never think about they will never diagnose. How can we oldies help the younger ones to awareness?
Grace Warren
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML Archives: http://www.aifo.it/english/resources/online/lml-archives/index.htm
Contact: Dr Pieter Schreuder << editorlml@gmail.com >>.
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