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2.  Lerprosy is a communicable disease which is
caused by a bacteria Micobacterium leprae. The

3.  Leprosy is caused by M. leprae. They are
acid-fast bacillus and occur in the human
host. They have an affinity for Schwann
cells and cells of the reticulo-endothelial
system.

4.  All patients with "active
leprosy" are considered
infectious. Human cases of
leprosy are main source of
infection.

5.  Nose is a major portal of exit. Lepromatous cases
harbour millions of M. leprae in their nasal mucosa
which are discharged when they sneeze or blow the
nose. The bacilli can also exit through ulcerated or
broken skin of bacteriologically positive cases of
leprosy

6.  So it is clear that mode of transmission of leprosy is-
 Droplet infection - leprosy may be transmitted via aerosols
containing M. leprae .
 Direct contact - direct skin to skin contact with patient
 Indirect contact.- contact with soil, and fomites such as
contaminated clothes and linen

7.  Leprosy has a long incubation period, an
average of 3 to 5 years or more for lepromatous
cases. The tuberculoid leprosy is thought to
have a shorter incubation period

8.  a. hypo-pigmented patches
 b. partial or total loss of cutaneous
sensation in the affected areas (the
earliest sensation to be affected is
usually light touch)

9.  c. presence of thickened
nerves, and
 d. presence of nodules or
lumps especially in the skin of
the face and ears.

10.  e. presence of deformities such as
plantar ulcers loss of fingers or
toes, nasal depression, foot-drop,
claw toes etc.

11.  Leprosy is classified as-
 Indeterminate
 Tuberculoid;
 Borderline
 Lepromatous

12.  In this types of leprosy cases are in early
stage with one or two vague hypopigmented
macules and definite sensory impairment.
The lesions are bacteriologically negative

13.  In this types of leprosy cases are in slight advance
stage with one or two well-defined lesions, which
may be flat or raised, hypopigmented or
erythematous and are anaesthetic. The lesions are
bacteriologically negative.

14.  In this types of leprosy cases are in slight more
advance stage with four or more lesions which may
be flat or raised, well or illdefined, hypopigmented
or erythematous and show sensory impairment or
loss. The bacteriological positivity of these lesions
is variable.

15.  In this types of leprosy cases are in advance stage
with diffuse infiltration or numerous flat or raised,
poorly defined, shiny, smooth, symmetrically
distributed lesions. These lesions are
bacteriologically positive,

16.  (i) Physical examination : Presence of
sign and symptoms such as hypopigmented
leisons, loss of sensations may provide an
idea for leprosy.

17.  (ii) Bacteriological Examination : skin
smear, nasal smear or nasal scraping
examination by zeihl neelsen method will
provide clear indication about leprosy.

18.  (iii) other tests : other tests includes-
 Histamine test
 Lepromin test
 Skin Biopsy etc.

19.  Leprosy is treated by MDT.
 Multi drug therapy includes antibacterial
drugs such as rifampicin, dapsone,
clofazimine, ethionamide and protionamide

20.  For providing MDT leprosy cases are divided in two groups as
per sign and symptoms as:
 (i) Paucibacillary leprosy : A person having 1-5 skin
lesions and/or only one nerve involvement
( 6 month treatment)
 Rifampicin- 600 mg once a month, supervised
 • Dapsone- 100 mg daily, self-administered

21.  (ii) Multibacillary leprosy : A person having 6 or more skin
lesions and/or more than one nerve involvement
 ( 12 month treatment)
 • Rifampicin-600 mg, once monthly, given under supervision
 • Dapsone-100 mg daily, self-administered
 • Clofazimine -300 mg once monthly supervised; and 50 mg
daily, self-administered.


22.  Rehabilitation is the part of treatment of leprosy it
means "the physical and mental restoration, as
far as possible, of all treated patients to normal
activity, so that they may be able ta resume their
place in the home, society and industry".

23. By – SURESH KUMAR ( Nursing Tutor )