01413nas a2200217   4500000000100000008004100001260001300042653003100055653002100086653001100107653001200118653002500130100001700155700001900172700001600191245008600207300001100293490000700304520087000311022001401181       1991                            d  c1991 Feb10aEmergency Medical Services10aErythema Nodosum10aHumans10aleprosy10aLeprosy, lepromatous1 aGoodless D R1 aRamos-Caro F A1 aFlowers F P00aReactional states in Hansen's disease: practical aspects of emergency management.  a237-410 v843 a<p>Hansen's disease (leprosy), though not a common condition in the United States, can be found in some localities among patients who come to the emergency room for treatment. Hansen's disease (HD) is a chronic systemic infectious granulomatous disease involving principally the skin, mucosa, nerves, and eyes. The causative organism, Mycobacterium leprae, is neither highly contagious nor aggressive, but rapid alterations in the immunologic response to M leprae in affected tissues can result in acute exacerbations termed "reactions." Since most of the symptoms and morbidity in HD are a consequence of these reactional states, they must be recognized and treated early to prevent permanent sequelae, especially neurologic and ophthalmologic. Drug therapy, physical therapy, and sometimes surgery all play a role in minimizing the injury caused by reactions.</p>  a0038-4348