Rarity of disease in UK may lead to errors, says dermatologist, after two cases in Cardiff diagnosed as common skin complaints

People with leprosy might be being misdiagnosed because of the rarity of the disease in Britain, doctors will be told on Monday.

Dermatologists from Cardiff reported two cases in which men who had moved to Britain from Asia were initially thought to have more common skin complaints.

They say the disease – historically one associated with stigma and fear, though it is now curable – may be "masquerading" as other conditions because of the broad range of symptoms.

Ausama Atwan, who will outline the concerns at the Glasgow conference of the British Association of Dermatologists, said the team were not out to alarm people "but it is certainly something that doctors should be mindful of if they encounter patients, especially those originally from endemic countries, with persistent or unexplained lesions, changes to skin pigmentation and sensation."

Given the disease's rarity in Europe, Atwan said "it may easily be misdiagnosed and consequently pose future health risks for patients if missed". There have been no cases confirmed of patients acquiring the disease or catching it from someone else in England and Wales for 60 years. However there were 129 cases "imported" from people who had lived in endemic countries, often in south Asia, reported between 2001 and 2010. Public Health England(PHE) said another 38 occurred between 2011 and 2013. Nearly 233,000 cases were reported globally in 2012.

The cases identified at the University Hospital of Wales at 2010 and 2013 were in men who came from Asia. One was 25 and had experienced changes to his skin colour and sensation on the left side of his face. He had at first been treated for a skin infection and a rash. The other, aged 35, had patches of skin lightening over his body, raised red areas on his forehead and circular lesions on his legs. He had been first diagnosed as having a type of eczema.

Leprosy is not highly contagious and the bacteria responsible multiply slowly so the disease can take 20 years to become apparent. Reduced circulation, muscle loss, and ultimately limb deformity and disability only occur in a minority of cases. With early detection and the correct multi-drug treatment, it is curable. American researchers hope to start trials of a vaccine next year.

Prof Ibrahim Abubakar, PHE's expert on leprosy, said: "Leprosy is an extremely rare disease in England and Wales, and all cases are imported. However it remains an important disease globally with 232,857 cases diagnosed in 2012. Although rare in the UK, it is important that people with suspected leprosy receive early diagnosis and expert treatment, using the Public Health England guidance published in the Memorandum on Leprosy".