What is leprosy?
A cronic infectious disease caused by mycobacterium laprae (an acid- fast, rod shaped bacillus) and mainly affecting the skin, peripheral nerve, mucosal surface of the upper respiratory tract and eyes is termed leprosy or hansen's disease.
other name of hansen's disease. It occurs at all age ranging from infants to elderly individuals laprosy is curable and early treatment can prevent for the disabilities.
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What causes leprosy
Leprosy is a chronicle infection disease caused by the acid- fast bacili mycobacterium leprae and mycobacterium laparomatosis.
It is a moderately cantagious bacteria and its transmission requires prolonged direct contact with an infected individual. inoculation through respiratory tract is believed to be potential mode of transmission of infection .
Types
Leprosy can be classified as follows
on the basic of clinical manifestation and skin Simear results.
i.) Paucibacillary leprosy (PB):
In this types, the patient show negative smears all sites.
ii.) Multibacillary leprosy ( MB);
In this types, the patient show positive smears at all site.
Redley And jopling classification:
In 1996 redley and jopling developed a classification system for laprosy based on the symptoms and immunological findings in which leprosy was classification into 6 types:
- Intermediate leprosy
- Tuberculiod (TT)
- Borderline tuberculiod (BT)
- Midborderline (MB)
- Borderline tuberculoid (BL)
- Leprometous leprosy (LL)
Causes of leprosy
Leprosy is a chronicle infection disease caused by the acid- fast bacili mycobacterium leprae and mycobacterium lapromatosis.
It is a moderately cantaginous bacteria and its transmission requires prolonged direct contact with an infected individual. inoculation through respiratory tract is believed to be potential mode of transmission of infection .
The incubation period of leprosy is up to 5 years for the tuberculiod form and 12 year for the leprometous form.
The causative agent of leprosy is the bacillus , mycobacterium laprae. it is an intra -cytoplasmic parasite of microphages and Schwam cells .
Tuberculiod leprosy is the variant seen in individuals with a high level of specific cell mediated immunity.
Sign in symptoms of leprosy
The bacteria causing leprosy grow very slowly. the symptoms may appear within 2 to 10 years and mainly affect the skin, nerves, and mucous membrane. in 22-60% of cases in the oral lesions appear as multiple nodules ( ulcerative and necrotic) in the leprometous form.
These lesions show slow healing and atrophic scarring..
The most common first clinical manifestation is spots on the skin that may be slightly Red ,darker and hypopigmented ( Lighter coloured as compare to skin ). some of these spots may gradually increase in size and new spots may also appear on other body parts.
- Faded or discolored skin lessions.
- Growth on the skin
- Thick,stiff,or dry skin
- Sever pain
- Numberness on affective areas of the skin
- Muscles weakness or paralysis
- Eye problem that may lead to blindness
- Enlarged nerves
- A stuff nose
- Nosebleeds
- Ulcer on the soles of feet
Complication
- Delayed diagnosis and treatment of leprosy can be lead to the following serous complication:
- Disfigurement
- Hair loss
- Muscles weakness
- Parmanent nerves damage in arm and legs
- Inability to use hands and feet.
- Chronic nasal congestion, nosebleed, collapsed of the nasal septum
- Iritis
- Glaucoma
- Blindness
- Kidney failure
Diagnosis of leprosy
1. Clinical diagnosis
it involves the study of history of contact with an infected patient or the sign and symptoms experienced by the patient like;
i.) hypopigmented or reddish skin lesion with definite loss of sensation .
ii.) Involvement of the peripheral nerve , as demonstrate by the loss of sensation and muscles weakness of hands , feet or face.
2. Laboratory test:
These tests for diagnosis leprosy include
3. Lepromin test;
This taste is specific for lepromatous laprosy. in the test ,about 0.1 ml of suspension of killed becillis is injected under the skin . The response to 70 hours is termed as Fernandez reaction.it indicates previous exposure to the antigen of M.leprae .
4. Biopsy:
lesions sample are stained with an acid fast stain and analysed. This shows the presence of bacillis in the tissue of typing dermal granulomas in tuberculiod leprosy.
5. Tissue/Slit -skin Smear test.
Treatment of leprosy
Several drugs are used in combination in multi drug therapy ( MDT) . These drugs should be used alone as monotherapy for leprosy.
Dapsone alone was the mainstay treatment for leprosy since many years until widespread resistant strains appeared.therfore, combination therapy has Become essential to slow or prevent the development resistance.
Rifampicin is now combined with Dapsone to treat paucibacillary laprosy. Rifampicin and clofazimine are combined with debsone to treat multibacillary leprosy in the following ratio;
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