[Leprosy in children: A diagnosis that must not be missed].
BACKGROUND
With 254,525 new cases reported in 2007, leprosy is the worlds' second most widespread form of mycobacteriosis. According to the WHO, eradication of leprosy as a public health problem (defined by less than one case per 10,000 people) has been globally achieved. High endemic zones, however, still subsist. Leprosy rates among children, which reflect a country's endemic level, ranged from 0.55 to 19.2 % in 2006. Due to world population migrations, cases of leprosy are now seen in mainland France, in both children and adults.


METHODS
We describe three leprosy patients aged under 15 years treated at the Dermatology Unit of Saint Louis Hospital between 1st January 2002 and 31st December 2008. The three cases described account for 3 % of new patients treated for leprosy at Saint Louis Hospital over this 7-year period. All were born in an endemic country. Lesions appeared 18 months after arrival in France in two cases and clinical diagnosis was made in only one case. Due to absence of sensory loss in the lesions, diagnosis was reliant upon histopathological examination in two cases.


CONCLUSIONS
Leprosy should be suspected in children from endemic countries presenting skin lesions, particularly hypochromic lesions, even if there is no sensory loss, regardless of how long they have been living in France.
Frémont
G
G
Service de dermatologie, université Denis-Diderot Paris 7, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
Bourrat
E
E
Mahé
E
E
Flageul
B
B
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D017668:Age of Onset; D001706:Biopsy; D001938:Brazil / Q000208:ethnology; D002648:Child; D004359:Drug Therapy, Combination; D019353:Endemic Diseases; D005260:Female; D005602:France / Q000453:epidemiology; D016701:Guinea / Q000208:ethnology; D006801:Humans; D007194:India / Q000208:ethnology; D007918:Leprosy / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use; D012867:Skin / Q000473:pathology
D000305:Adrenal Cortex Hormones; D012293:Rifampin