Physicians in the United States may encounter Hansen's disease in immigrants and in patients from endemic areas such as Texas, Louisiana, Hawaii, and California. Exposure to infected armadillos may be one means of acquiring the disease. The Mycobacterium leprae bacillus has a predilection for nerves and skin in the cooler areas of the body. The limited tuberculoid form of the disease is characterized by one or a few hypoesthetic skin lesions and palpably enlarged nerves. The more extensive lepromatous form of the disease appears as multiple nodular skin lesions, sometimes with involvement of the nasal structures and eye. Current recommended regimens for treatment of Hansen's disease are based on combinations of dapsone, rifampin, and clofazimine. Recent advances in treatment have resulted in a significant decline in the worldwide prevalence of the disease.
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