<p style="text-align: justify;" data-mce-style="text-align: justify;">Hansen’s disease remains a critical health issue in tropical countries like the Philippines. Delayed diagnosis, especially in the context of indiscriminate corticosteroid use, can lead to severe complications. This case highlights the importance of proper referral, ruling out infections, and cautious steroid use.p><p style="text-align: justify;" data-mce-style="text-align: justify;">
p><p style="text-align: justify;" data-mce-style="text-align: justify;">A 29-year-old Filipino male presented with a 4-year history of erythematous, scaly plaques on his face and scalp, for which he had not sought treatment. One year later, the plaques spread to his trunk, accompanied by arthralgia. Misdiagnosed with psoriasis, he self-medicated with clobetasol and dexamethasone for three years. Over time, he developed signs of Cushing syndrome. Two months before consultation, after a fall, he experienced lower extremity weakness, hypoesthetic plaques on his legs, and blurred vision, but continued using steroids. Upon admission, he was diagnosed with iatrogenic Cushing syndrome. Steroid tapering reduced generalized edema, revealing nodules on his ears and extremities. Slit-skin smear and histopathology confirmed Hansen’s disease. Unfortunately, he succumbed to septic shock before completing treatment.p><p style="text-align: justify;" data-mce-style="text-align: justify;">
p><p style="text-align: justify;" data-mce-style="text-align: justify;">Misdiagnosis and prolonged steroid use pose risks by masking infections like leprosy. In regions where infectious diseases are prevalent, clinicians should exercise caution before prescribing steroids, as overuse can lead to “therapeutic incognito,” complicating diagnosis. Early referral to dermatologists for undiagnosed or refractory skin lesions is critical in preventing complications. This case emphasizes the importance of educating healthcare providers on judicious steroid use and ruling out infections. Delayed diagnosis of leprosy, as demonstrated here, can lead to severe outcomes, reinforcing the need for timely intervention and thorough patient evaluation.p>
Human ; Male ; Adult: 25-44 Yrs Old ; Infectious Disease ; Communicable Diseases ; Leprosy

Background: Due to the high prevalence and incidence of leprosy in the Philippines, there is a continuing need to detect and document the occurrence of dapsone-induced hemolytic anemia. Objective: The aim of this study is to determine the incidence of dapsone-induced hemolytic anemia in non-glucose-6-phosphate dehydrogenase deficient leprosy patients receiving multidrug therapy (MDT) in Southern Philippines Medical Center. Methodology: This is a retrospective study through chart review of leprosy patients treated with MDT regimen at Southern Philippines Medical Center from January 2016 to December 2018. The demographic profile, clinical characteristics, hemoglobin and hematocrit concentrations before and after initiation of MDT, the presence of symptoms of anemia, and the occurrence of dapsone-induced hemolytic anemia in leprosy patients were collected. The main outcome measure for this study was the incidence rate of dapsone- induced hemolytic anemia. Statistical-based analysis were used for continuous and categorical data which were summarized using means and standard deviations, and frequencies and percentages, respectively. Results: There was a decrease in the mean hemoglobin and hematocrit levels noted in the majority of patients after initiation of MDT from baseline 143.46 g/dl and 0.44, respectively, to 94 g/dl and 0.28 on the third month of MDT. The incidence rate of dapsone-induced hemolytic anemia during the 3-year period was 20 cases per 100. Conclusion The relatively high incidence rate of dapsone-induced hemolytic anemia highlights the importance of frequent monitoring of hemoglobin and hematocrit concentrations in leprosy patients being treated with multidrug therapy.
Hansen&rsquo ; s disease ; leprosy ; Dapsone ; hemolytic anemia