Analysis of newly detected leprosy cases and misdiagnosis in Wuhan (1990-2004).

OBJECTIVE: To analyse the leprosy epidemiological trends and the diagnostic delay in newly detected cases between 1990 and 2004 in Wuhan.

METHODS: We reviewed the clinical records of all 80 leprosy patients who were referred to the Wuhan Institute of Dermatology and Venerology (WHIDV) during 1990 and 2004, and the clinical information of diagnosis-delayed cases was analysed.

RESULTS: Patients were determined as lepromatous leprosy (LL, 24, 30%), borderline lepromatous leprosy (BL, 15, 18-75%), borderline leprosy (BB, 9, 11.25%), borderline tuberculoid leprosy (BT, 12, 15%), and tuberculoid leprosy (TT, 20, 25%), respectively. The patients were more likely to present with multibacillary (MB, 48 cases) rather than with paucibacillary (PB, 32 cases). Among the 80 newly detected patients, 53 cases (66.25%) had been misdiagnosed (51 cases in general hospitals, two cases in WHIDV), 23 cases were treated with hospitalisation in department of dermatology of general hospitals. Up to 20 kinds of dermatological conditions involved in case misdiagnosis.

CONCLUSIONS: Misdiagnosis of dermatological conditions and ignorance of the disease among general practitioners and hospital dermatologists were the main causes of diagnostic delay in Wuhan. which is leading to incorrect treatment for patients suffering with a variety of damage due to leprosy.