Claw hand is the most common deformity in leprosy:
- It is due to paralysis of the intrinsic muscles hand which is innervated by the median and/or ulnar nerves.
- Leads to hyperextension of MCP (metacarophalangeal) joints and flexion of the IP (interphalangeal) joints.
Management consists of occupational therapy and/or reconstruction surgery.
In this case report from Indonesia the authors report a 32 year old male with hyperesthetic red plaques and punched out lesions on the arms and legs:
- Once diagnosed, he was treated with MDT (multi-drug treatment) and reeducation
- sensory reeducation: introducing hands into objects (circle, square), texture (rough, smooth) and handling of other known objects
- occupational therapy (manipulating objects)Reeducation consisted of Result was subjective improvement reported by the patient on day 29: “decrease in stiffness and movement difficulty 2nd finger left hand and 5th finger right hand”.
Conclusion: although reeducation is possible, prevention is better and this consists of treating Hansen’s at its early stages.
Source of Information: Yuwita W – Claw Hand in Mild Borderline Leprosy Treated with Sensory Re-education. 2014 (4) – 21st Regional Conference of Dermatology; Danang (Vietnam)