Leprosy introduction, sign and symptoms and treatment

Leprosy

Chronic granulomatous disease cauesd by mycobacterium leprae
Spreads by droplets infection -lapromatous patient whose nasal heavily infected.

Leprosy disease

Pathology

Organism predilection(paralysis)
For peripheral nerve,skin and mucous of upper respiratory tract.
Early infection is transient and self healing called indeterminate.

Types

Tuberculoid -gradual onset
First symptoms small but persistent Area of impaired sensation and numbness.
In some patient hypopigmentation and erythematous macule may be first symptoms.

Nerve lesions -sensory and motor symptoms arise depends on nerve involved.
Superficial personeal nerve
Posterior tibial nerve
Median nerve at carpel tunnel
Radial nerve at wrist.

Skin lesions -
Macules occurring
Most common at lateral aspect of arms, legs, buttock and shoulder.
Characteristics -
Defined edge, hypopigmented, loss of sensation, dry, scaly and anhydrosis skin.

Lapromatous -commence appearance
Small, Numerous and widely scattered on body .
Symmetrical and margine merge imperceptibly(not easily defined) with normal skin.
Overlying sensation is not Impaired.

Borderline -mixture of above both types.

Other classification
Multibacillary (Lapromatous and Borderline)-more than 5 or more skin lesions.
Bacterium detected in skin lesions.

Management -

combination of three drugs

Rifamcine -600mg daily 4 weeks
Dapsone -50-100mg daily for whole life
Clofazimine -100mg three times a week for 1 year.

Paucibacillary( Tuberculoid and Borderline)-fewer than 5 lesions.
Bacterium difficult to detect in skin lesions.

Management -

Dapsone 25-50mg daily for 3-10 years.

Milan Tomic

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