A nine-year clinico-epidemiological study of Histoid Hansen in India

Introduction: Histoid Hansen is rare but a well-defined entity with specific clinical, histopathological, and bacteriological features. The incidence has been reported to vary from 1-2% amongst total leprosy patients. Methodology: We performed a retrospective analysis of the records of patients identified as histoid Hansen on the basis of clinico-histopathological criteria, who attended the Hansen clinic from 2000-2009. Results: A total of 962 leprosy patients attended the Hansen clinic from 2000-2009, and of these, 11 (1.14%) were diagnosed as histoid Hansen. The youngest patient on record was 14 years of age. Nearly 70% of the patients were untreated and the rest were on multidrug therapy (MDT) before development of histoid lesions. Three patients showed Erythema nodusum leposum (ENL) reaction. Conclusion: India has achieved elimination of leprosy, but new cases of histoid are still recorded with the same incidence rate. Reactions are not uncommon in such forms, and may be a transition phase to manifest lepromatous leprosy. A thorough knowledge and early detection is needed for this uncommon variant of leprosy which can pose a threat to our elimination drive.