Naaman is described as suffering from a ‘sâra’at’, the Hebrew word for a skin condition causing ritual uncleanness.[1] There is no description of Naaman’s actual features, but we do know that he was still able to appear in person before the king of Aram. Also we are told that due to the greed of Elisha’s servant, Gehazi, Naaman’s skin condition was transferred to him and he became white as snow. We are told that this disease would cling to Gehazi and his descendants forever. So what could be the dermatological disorder that Namaan suffered from?

The transferral of this disease from Naaman to Gehazi leads us away from non-transmissible conditions such as eczema and psoriasis, which can be similar to the skin lesions of leprosy, as well as vitiligo (associated with autoimmune diseases such as Addison’s disease). Vitiligo also does not usually cause the psychological and physical distress which are evident in this passage. Post-inflammatory hypopigmentation is the most common cause of leucoderma (white skin) and in some parts of the world this is commonly due to discoid lupus erythematosus.

Infective causes of leucoderma include leprosy, syphilis and pitiriasis versicolor (a yeast infection). Some have argued that Gehazi may have caught scabies from the two sets of clothes that Naaman gave him.[1] Indeed scabies can produce lesions of urticaria and eczema, though papular-vesicular lesions are the most common form. Scaly plaques can occur and in chronic cases, especially those caused by Norwegian mites, lichenification is common, leading to leucoderma. The mites can easily be passed to other members of the family and the whole body can be affected. Interestingly the sulphur containing waters of waters of Rabbi Mayer near Tiberias were reputedly curative of scabies and sufferers were exhorted to dip into the waters seven times.[2] We would generally treat scabies by applying malathion 0.5%, lindain 1% or permethrin 1% as a cream or lotion over the whole body to be left for 24 hours and washed off. In India the ancient remedy of pyrethrum is still used today.[3]