Case Report

Advanced Craniofacial Manifestations of Hansen’s Disease: A Case of Madarosis, Septal Perforation, and Saddle Nose Deformity

Abstract

Hansen’s disease (leprosy) is a chronic granulomatous infection caused by Mycobacterium leprae that primarily affects the skin and peripheral nerves but may also involve the upper respiratory tract, resulting in significant craniofacial deformities. Although the widespread use of multidrug therapy (MDT) has markedly reduced disease prevalence, delayed diagnosis continues to result in advanced presentations in endemic regions. We report a case of advanced multibacillary Hansen’s disease presenting with bilateral madarosis, nasal septal perforation, and saddle nose deformity, representing classical but increasingly uncommon manifestations of longstanding disease. Clinical examination, supported by appropriate microbiological and histopathological investigations, established the diagnosis while excluding other causes of destructive midline nasal lesions. The patient was managed with WHO-recommended MDT and multidisciplinary care, with reconstructive surgery planned after disease inactivity. This case highlights the importance of early recognition of characteristic craniofacial manifestations to facilitate timely treatment, prevent irreversible tissue destruction, reduce disability, and improve both functional and psychosocial outcomes in patients from leprosy-endemic regions.

Authors affiliation:

Avinash Kumar (ORCID): Department of Otorhinolaryngology- Head and Neck Surgery, Saraswathi Institute of Medical Sciences (SIMS), Anwarpur, Hapur, Uttar Pradesh, India
Chandan Kumar: Department of Otorhinolaryngology- Head and Neck Surgery, Saraswathi Institute of Medical Sciences (SIMS), Anwarpur, Hapur, Uttar Pradesh, India
Chirag Titoria: Department of Otorhinolaryngology- Head and Neck Surgery, Saraswathi Institute of Medical Sciences (SIMS), Anwarpur, Hapur, Uttar Pradesh, India
Garima Sinha (ORCID): Department of Pharmacology, Bidar Institute of Medical Sciences, Bidar, Affiliated to RGUHS Bengaluru, Karnataka - 585401, India.
Preeti Bani: Department of Otorhinolaryngology- Head and Neck Surgery, Saraswathi Institute of Medical Sciences (SIMS), Anwarpur, Hapur, Uttar Pradesh, India
Thajana Devi Khwairakpam: Department of Otorhinolaryngology- Head and Neck Surgery, Saraswathi Institute of Medical Sciences (SIMS), Anwarpur, Hapur, Uttar Pradesh, India

How to Cite: A. Kumar, C. Kumar, C. Titoria, G. Sinha, P. Bani and T.D. Khwairakpam. Advanced Craniofacial Manifestations of Hansen’s Disease: A Case of Madarosis, Septal Perforation, and Saddle Nose Deformity. Journal of Applied Health Sciences and Medicine, 6(8):1–5, 2026. https://doi.org/10.58614/jahsm681