Efficiency of the Sensory Mapping Score for Hansens's disease diagnosis and follow-up: a functional cure criterion?

Introduction: Current operational criteria for Hansen's disease (HD), which are primarily based on lesion count and fixed-duration multidrug therapy, tend to overlook the neurological spectrum of the disease and fail to define cure in terms of functional recovery. The objective was to develop and validate a Sensitive Mapping Score using Semmes-Weinstein Monofilaments to assess and monitor cutaneous sensory impairment in HD lesions during treatment with the RIMOXCLAMIN regimen. Methods: A prospective cohort of 40 patients was followed over a 12-month period. Tactile sensitivity was evaluated in the hands, feet, and cutaneous lesions at 3-month intervals using a standardized SWM mapping system. Color-coded responses were converted into a numerical score reflecting the degree of sensory impairment. Clinical, neurological, and laboratory parameters were assessed in parallel. Results: Although only 32.5% of patients met the multibacillary classification based on lesion count, 100% exhibited altered tactile sensation and 80% presented with nerve thickening. The SMS demonstrated early sensitivity to neurological improvement, with significant changes observed by the third month ( Conclusion: The SMS is a low-cost, accessible, and objective tool for neurological monitoring in HD. It quantifies functional recovery in cutaneous lesions, offering a clinically meaningful alternative to the concept of an "administrative cure." Its adoption could guide individualized treatment durations, enhance therapeutic decision-making, and promote a shift toward function-based definitions of cure in HD management.