LEPROSY
(Communicable disease)
What is leprosy?
🔹Alternative Name of Leprosy:Hansen’s disease
🔹Leprosy is an infectious disease.
🔹derived from the French work “leper” and from the Greek word “lepros”
which means scaly, referring to the scales that form on the skin.
🔹A infectiuos bacterial disease of the skin, peripheral nerves and
mucosa of the upper airway.
🔹Only few from who exposed to infection develop the disease.
Causative Organism
• Mycobacterium leprae and Mycobacterium lepromatosis are
the causative agents of leprosy.
• The rod-shaped bacilli
• grow slowly
• mainly affect the skin, nerves, and
mucous membrane
• They are acid fast.
Incubation period:
3-5 years
🔶The symptoms can take as long as 20 years to appear.
Mode of Transmission
a. Droplet infection- There is more and more evidence that leprosy may be
transmitted via aerosols containing M. Leprae with the realization of the
importance of the nose as a portal of exit, there has been increased
emphasis on the respiratory tract as the portal of entry.
b. Contact transmission-Transmitted fromperson to person by close contact
between an infectious patient and a healthy but susceptible person e.g.
Contact with soil and fomites such as contaminated cloths and linen.
c. Other routes- bacilli may also be transmitted by insect vectors, or by
tattooing needles
🔸Classification:
Indian classifications is official clasofication of Indian leprosy associated (Hindu
Kushta nivarana sangh.)
1.Indeterminate type-
- this denotes early cases with one or two vague hypo pigmented macules
- definite sensory impairment.
- These lesions are bacteriologically negative.
2.Tuberculoid type-
- this type denotes those cases with one or two well defined lesions, which may be flat
- or raised hypo pigmented or erythematous and are anesthetic.
- The lesions are bacteriologically negative.
3.Borderline type-
- this
type denotes those cases with four or more lesions
which may be flat or raised well or ill defined,
- hypo pigmented or erythematous and
- show sensory impairment or loss.
- The bacteriologically positive.
4.Lepromatus type-
- thistype denotes those cases with diffuse infiltration
- numerous flat or raised poorly defined, shiny, smooth, symmetrically
distributed lesions.
- These lesions are bacteriologically positive.
Pure neuritic type-
- Thistype denotes those cases of leprosy which show nerve involvement
- but do not have any lesion in the skin.
-These Case are bacteriologically negative.
Diagnosis
There are many kinds of leprosy but there are common symptoms including:
1. Runny nose
2. Dry scalp eye problems
3. Skin lesions
4. Muscle weakness
5. Reddish skin
6. Smooth shiny diffuse thickening of facial skin, ear, and hand
7. Loss of sensation in fingers and toes 8. Thickening of peripheral nerves
9. Flat nose due to destruction of nasal cartilage.
10. There is also phonation and resonation of sound during speech.
11. Often there is atrophy of the testes and impotency.
Clinical examination:
1.Interogation
2.Inspection
a. Skin smear-for examination of acid fast bacteria
b. Nasal smear
c. Nasal scrapping
d. Foot pad culture
e. Histamine test
f. Immunological test-cell mediated immunity
g. Biopsy
h. Lepromine test -used to distinguish lepromatous
from tuberculoid leprosy
i. FLA- ABS test-92.3 %
Treatment
Treatment:
Multidrug Therapy (MDT)-
🟠In a recent trial, a single dose of rifampicin reduced the rate at which contacts acquired
leprosy in the two years after the contact by 57%; 265 treatments with rifampicin
prevented one case of leprosy in this period. A non- Mode randomized study found that
rifampicin reduced the number of new cases of leprosy by 75% after three year
🟣BCG offers a variable amount of protection against leprosy as well as against
tuberculosis.
🟢Sulfone drug, e.g. Dapsone was discovered in 1943 for the treatment of leprosy.
🟡Other drug used in leprosy clofazimine, ethionamide, quinolones, minocycline,
clarithromycin.
Duration of treatment-
1.Multibacillary leprosy- MB blister pack for 12
months.
2.Paucibacillary leprosy- PB blister pack for 6
months.
Prevention
🔹Avoiding physical contact with untreated people
🔹People who are in immediate contact with the leprosy patient should
be tested for leprosy.
🔹Annual examinations
🔹Comprehensive care involves teaching patients to care for
themselves.
🔹Physiotherapy exercises are taught to the patients to prevent the
deformities from worsening
