The incidence of Hansen's disease is increasing in the United States. Early diagnosis can prevent irreparable damage. Sensory changes are often the first manifestations of tuberculous leprosy. In the lepromatous form, a variety of skin lesions pose diagnostic puzzles. The definitive diagnosis is made by histopathologic examination of skin or mucosa. Multidrug therapy, specifically dapsone and rifampin, is recommended for all newly diagnosed leprosy patients. In cases of untreated borderline or lepromatous leprosy, dapsone prophylaxis is advised for family contacts under 25 years of age.
