01583nas a2200349   4500000000100000008004100001260001700042653001000059653001100069653001000080653002100090653002800111653001800139653000900157653001100166653001100177653001200188653000900200653001600209653000900225653001100234653001600245653002000261100002000281700001800301700002500319245003700344300001100381490000700392520082000399022001401219       2005                            d  c2005 Sep-Oct10aAdult10aBiopsy10aChild10aChild, Preschool10aDiagnosis, Differential10aEar, External10aFace10aFemale10aHumans10aleprosy10aMale10aMiddle Aged10aSkin10aThorax10aUlnar nerve10aUpper Extremity1 aRamos-E-Silva M1 aOliveira MLWD1 aMunhoz-da-Fontoura G00aLeprosy: uncommon presentations.  a509-140 v233 a<p>The uniqueness of the clinical-dermatologic elements of leprosy recommends that control programs worldwide should diagnose the disease based on the so-called main clinical signs: cutaneous-neurological lesions with sensitivity-motor alterations without obligatory bacteriologic or histopathologic examination. The recognition of initial signs and symptoms of Hansen disease sometimes presents difficulties for its diagnosis, especially considering the relevance of an early diagnosis and the present guidelines for performance of decentralized treatment of the patient in the basic health-care network. The clinical cases illustrating this article were selected because of the degree of difficulty found in the confirmation of their diagnoses that required a histopathologic and/or bacteriologic examination.</p>  a0738-081X