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COMPLICATIONS OF LEPROSY & ITS MANAGEMENT

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COMPLICATIONS OF LEPROSY & ITS MANAGEMENT

  1. 1. KUSHAL KUMAR
  2. 2. before/during/after •Not Type I •Change in host CMI •Seen in borderlines •Skin and nerve lesions Type II •Antigen antibody •Seen in LL & BL leprosy •Skin, nerve & systemic involvement
  3. 3. Erythema Nodosum Leprosum(ENL)  Erythematous.Tender .Subcutaneous.  Resolve in 7 to 10 days.  Associated with fever & joint pains.  May be vesicular, pustular & may ulcerate  Treatment:with CLOFAZIMINE Treat ‘Reaction’ as a Medical Emergency: Rest & Analgesics DOC-Prednisolone(40-60 mg) Taper gradually over 12-16 wks. All need a detailed Neuromuscular assessment by a physiotherapist.
  4. 4. ADVERVE EFFECT OF ANTI-LEPROTIC DRUGS: DRUGS MINOR MAJOR 1. RIFAMPICIN RED URINE JAUNDICE GIT UPSET HEPATITIS FLU LIKE SYNDROME SHOCK 2. DAPSONE GIT UPSET DAPSONE SYNDROME DRUG RASH AGRANULOCYTOSIS ANAEMIA HEMOLYTICANAEMIA 3. CLOFAZIMINE GIT UPSET ACUTE PAINABDOMEN DISCOLOURATIONOF SKIN ICHTHYOSIS
  5. 5. DISABILITIES
  6. 6. Specific deformities: facies leprosa
  7. 7. Paralytic deformities
  8. 8. 3)Anesthetic deformity :
  9. 9. WHO Grade 0 Grade 1 Grade 2 EYES Normal vision,lid gap,blinking. Corneal reflex weak Reduced vision,lagopht halmos. HANDS Normal sensation & m.power. Loss of feeling in the palm Visible damage:woun ds,claw hand,loss of tissue etc. FEET Normal sensation & m.power. Loss of feeling in the sole Visible damage:woun d,foot drop,loss of tissue.
  10. 10. Peripheral nerves Sensory Motor Autonomic Hypoaestesia / anaestesia Muscle paralysis Lack of sweating & sebum Ulcers Ulnar nerve Claw hand Radial nerve Wrist drop Lt. popliteal Foot drop Post. tibial Claw toes Facial lagophthalmous Dry skin Cracked skin Ulcers
  11. 11. COMPLICATIONS OF EYE
  12. 12. Involvment of the ophthalmic division of the (5th.) trigeminal nerve Corneal sensation imparment Patients ignore injuries keratitis, conjunctivitis and ulcers Involvment of zygomatic & temporal braches of the (7th.) facial nerve. Lagophthalmos Unable to close the eye (unbliking stare)
  13. 13. Care of eyes
  14. 14. PSYCHO- SOCIAL PROBLEMS
  15. 15. Rehabilitation
  16. 16. MILESTONES OF NLEP IN INDIA
  17. 17. National Leprosy Eradication Program • Started in 1955 as NLCP with the objective of early detection of cases and treatment with Dapsone monotherapy • It was made a centrally sponsored programme in 1980 • With the advent of Multi DrugTherapy (MDT) for leprosy the cure rates increased It was changed into eradication programme in 1983 with the objective of eradicating the disease by the end of 2000 The ‘elimination’ was defined as attaining a prevalence Rate (PR) of less than 1 case per 10,000 population
  18. 18. Milestones of leprosy Eradication phase I phase II
  19. 19. Conclusion •Fortunately, modern medicine has cured most of the world of Leprosy •People with Leprosy are being more accepted by communities around the world •Leprosy still Remains a problem in undeveloped countries • The World Health Organization is putting a stop to this • If they reach their goal, Leprosy should be eliminated from the world within 20 years

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