Introduction, Pathophysiology, Transmission, Treatment,Side effect .

1. Submitted by:
Name: Netra Prasad Neupane
I.D : 17BPH080
Subject : Clinical Pharmacy

2.  I would like to express my special thanks of
gratitude to my teacher Dr. Pushparaj Gupta as
well as our HOD Dr. P. Malairajan who gave me
the golden opportunity to do this wonderful
project on the topic Leprosy, which also helped
me in doing a lot of Research and i came to know
about so many new things I am really thankful to
them.
Secondly i would also like to thank my parents
and friends who helped me a lot in finalizing this
project within the limited time frame.

3. Leprosy, also known as Hansen's disease, is a
chronic infectious disease caused by
Mycobacterium leprae. The disease mainly affects
the skin, the peripheral nerves, mucosal surfaces
of the upper respiratory tract and the
eyes. Leprosy is known to occur at all ages
ranging from early infancy to very old age.

5. The disease mainly affects the skin, the
peripheral nerves, mucosal surfaces of the
upper respiratory tract and the eyes. Leprosy
is known to occur at all ages ranging from
early infancy to very old age. Leprosy is
curable and early treatment averts most
disabilities.

6.  Leprosy can manifest in different forms, depending
on the host response to the organism.
 Individuals who have a vigorous cellular immune
response to M leprae have the tuberculoid form of
the disease that usually involves the skin and
peripheral nerves. The number of skin lesions is
limited, and they tend to be dry and hypoesthetic.
Nerve involvement is usually asymmetric. This form
of the disease is also referred to as paucibacillary
leprosy because of the low number of bacteria in the
skin lesions (ie, < 5 skin lesions, with absence of
organisms on smear). Results of skin tests with
antigen from killed organisms are positive in these
individuals.

7.  Individuals with minimal cellular immune response
have the lepromatous form of the disease, which is
characterized by extensive skin involvement. Skin
lesions are often described as infiltrated nodules and
plaques, and nerve involvement tends to be
symmetric in distribution. The organism grows best
at 27-30°C; therefore, skin lesions tend to develop in
the cooler areas of the body, with sparing of the
groin, axilla, and scalp. This form of the disease is
also referred to as multibacillary leprosy because of
the large number of bacteria found in the lesions (ie,
>6 lesions, with possible visualization of bacilli on
smear). Results of skin tests with antigen from killed
organisms are nonreactive.

8.  The exact mechanism of transmission of
leprosy is not known. At least until recently,
the most widely held belief was that the
disease was transmitted by contact between
cases of leprosy and healthy persons. More
recently the possibility of transmission by the
respiratory route is gaining ground. There are
also other possibilities such as transmission
through insects which cannot be completely
ruled out.

9. Clinical signs are easy to observe. In a country
or area with a high incidence of leprosy, an
individual should be regarded as having leprosy
if he or she shows ONE of the following cardinal
signs:
• skin lesion consistent with leprosy and with
definite sensory loss, with or without thickened
nerves
• positive skin smears

10. Leprosy is curable with a combination of drugs known
as multidrug therapy(MDT), as the treatment of
leprosy with only one antileprosy drug (monotherapy)
will result in development of drug resistance to that
drug. The combination of drugs used in the MDT
depends on the classification of the
disease. Rifampicin, the most important antileprosy
medicine, is included in the treatment of both types of
leprosy. For the treatment of patients with
multibacillary leprosy, WHO recommends a
combination of rifampicin, clofazimine and dapsone;
for patients with paucibacillary leprosy, MDT uses a
combination of rifampicin and dapsone.

11. When more than one drug is used, naturally
there is a risk of side-effects from each of the
drugs used in the combination. However, in
practice, the side-effects reported from the use
of MDT in several hundreds of thousands of
patients around the world show that most of
them are mild and major side-effects are rare.

12.  Textbook of Pathology by Harsh Mohan,
Seventh edition.
 A textbook of Clinical Pharmacy Practice :
Essential Concept by G Parthasarathi, Kairn
Nyfort-Hansen, Milap C Nahata.
 www.healthline.com/health/leprosy

13. Thank you !!!