INTRODUCTION

Leprosy, or Hansen's disease, is caused by the acid-fast, rod-like Mycobaterium leprae. Although effective treatment did not become available until the 1940s, the organism was discovered by Gerhard Henrik Armauer Hansen in 1873 and became the first bacterium known to cause disease in man. Since then, the dramatic, chronic, and debilitating consequences of the disease have been stigmatizing to those affected. Worldwide, it is still the most common cause of peripheral neuropathies, and is superseded in developed countries only by diabetes and alcoholism. Social containment and isolation are not just historical remnants, as those currently treated continue to face social challenges not only in the Third World but also in developed societies.

HISTORY

Hansen's disease has been reported as early as 1400 BC. Evidence of bone disease has been found in Egyptian mummies. During the 13th century, it became widespread in Europe, but it is still endemic in Portugal, Spain, Greece, and Italy.

Despite this fact, the early diagnosis and prevention of leprosy continues to escape health-care providers. In India, the Vedas included instructions for the prevention of leprosy, yet today we have been unable to identify cases early before neurologic and dermatologic sequelae ensue. Leprosy is still the main cause of peripheral neuropathies worldwide. As education programs become more prevalent and basic science evolves (the entire genome of Lepra is now sequenced), we hope that historical trends in incidence and disease progression will also change.