Clinical Manifestations: Standard nomenclature divides cases into five groups based on clinical, histopathologic, and immunologic findings: tuberculoid, borderline tuberculoid, borderline, borderline lepromatous, and lepromatous. The tuberculoid form of disease is most common in those with a vigorous immune response. In these patients infection is limited to a few places in the skin and peripheral nerves, manifesting with 1-6 erythematous plaques with sharp borders on the face, trunk, or extremities. These plaques are hairless, dry, and hypoesthetic. The number of bacteria in these lesions is low and they are therefore referred to as paucibacillary. Nerves may be palpably thickened secondary to inflammation in tuberculoid Hansen’s Disease (see Figure 1). Common nerves affected include: the great auricular nerve, common peroneal nerve, ulnar nerve, radial cutaneous nerve and the median nerve. At the other end of the spectrum, patients with minimal cellular immune response have lepromatous disease. Skin involvement is extensive with numerous bilateral macules and papules. The bacteria can infect the nasal mucosa resulting in stuffiness, discharge, epistaxis, and destruction of the nasal cartilage. Diffuse infiltration of the skin with bacteria results in the classic leonine facies (see Figure 2). Unusual presentations include erytema nodosum like leprosum (similar to erythema nodosum) and a form of lepromatous disease reported primarily in Mexican patients with diffuse infiltration and thickening of the skin, loss of eyebrows and body hair, and a necrotizing vasculitis termed "Lucio’s phenomenon."