To the Editor The review article on distal symmetric polyneuropathy by Dr Callaghan and colleagues1 did not address leprosy (Hansen disease), which may be the most common treatable peripheral nerve disorder worldwide.2 The major features of leprosy are anesthetic skin lesions, neuropathy, and positive skin smears for Mycobacterium leprae bacilli. The lepromatous form of leprosy is a slow, progressive, widespread disease of skin and nerves manifesting as bilateral, symmetrical, distal polyneuropathy. The tuberculoid and borderline forms of leprosy typically cause focal mononeuropathies and polyneuropathies. If untreated, the associated neuropathy causes deformity and permanent disability; however, early treatment is associated with good outcomes.2
Brown JD. Leprosy as a Cause of Distal Symmetric Polyneuropathy. JAMA. 2016;315(19):2123. doi:10.1001/jama.2016.1112
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