title: [Two cases of leprosy related conditions and relevant issues on medical services for ex-leprosy patients who live in communities in Japan].
abstract: In Japan people affected by leprosy who were forced to admit to national leprosy sanatoria under leprosy prevention/segregation law (1953) have ever been promoted to return to live in community, after destruction of the law in 1996. In this paper two cases are shown with some comments who had already been discharged from leprosy sanatoria and came late to OPD of National Suruga Sanatorium for consultations of their leprosy related conditions. One case is a 60 year-old male who developed squamous cell carcinoma (SCC) from chronic planter ulcer. The other is a 69 year-old female who developed relapse after more than 20 years BI negativity. In these cases, periods until consultation to our clinic were one year and five months, and five years and five months respectively. One reason is that there is no follow-up system of leprosy related conditions for ex-patients in current medical service of Japan. Another reason may be that patients hesitated to consult local doctors for their leprosy related conditions. Since national leprosy sanatoria will come to be closed in near future, services should be available for leprosy related conditions, such as prevention of disability (POD), prevention of worsening disability (POWD), early detection of relapse and leprosy reaction, in general medical service of Japan.
authors.affiliation: National Suruga Sanatorium, 1915 Kohyama, Gotemba-city, Shizuoka 412-0033, Japan. yishida@suruga.hosp.go.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ishida
authors.forename: Taro
authors.initials: T
authors.lastname: Inoue
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsuchiya
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Maeda
authors.forename: Akira
authors.initials: A
authors.lastname: Hirano
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D018289:Carcinoma, Verrucous / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002908:Chronic Disease; D003153:Community Health Services; D005260:Female; D016523:Foot Ulcer / Q000150:complications*; D006801:Humans; D007564:Japan; D007918:Leprosy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012878:Skin Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery