This document provides information about leprosy (Hansen's disease), including: 1. It is caused by Mycobacterium leprae bacteria and primarily affects nerves and skin. 2. It is classified based on clinical features into paucibacillary (tuberculoid) and multibacillary (lepromatous) types. 3. Symptoms vary but commonly include skin lesions and loss of sensation. Diagnosis involves skin smears, biopsy and lepromin testing.

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BY
VANA JAGAN MOHAN RAO M.S.Pharm, MED.CHEM
NIPER-KOLKATA
Asst.Professor, MIPER-KURNOOL
Email: jaganvana6@gmail.com

2. Leprosy (Hansen’s disease) is a chronic,
systemic infectious disease, affecting
primarily the peripheral nerves and
secondarily the skin, mucous membranes,
the eyes, bones, lymph nodes and viscera.
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Discovered by Gerhard
Armauer Hansen in 1873

3.  Chronic granulomatous infection caused by
Acid Fast Bacteria Mycobacterium leprae
(Ml)
 Ml cannot be grown on culture media--- in vitro
drug sensitivity is not possible
 Growth and Drug susceptibility are done
by injecting inoculate in mouse foot pad
 Live dormant in macrophages but alive
 Transmitted from person to person through
nose, skin lesions of the infected persons.
 Affect mainly PNS, NS, Skin and varioustissues
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5. Bacteria Resides in Cooler Parts of the
Body
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Skin Peripheral Nerves

6. Mode of infection:
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Leprosy is slow communicable disease and
uncubation period is between first exposure
and appearance of signs of disease.
Direct contact: Prolonged close contact of
susceptible individuals to an open case of
leprosy (damaged skin, nasal secretions,
mucous membrane contact).
Materno- foetal transmission.
Transmission from milk from mother to
infant.

7. Transmission
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 Nasal/oral Droplets
 Dermal Inoculations

8. Armadillo
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 They transmit
leprosy
 They act as animal
model along with
monkey, mice and
rabbit

9. Incidence
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 At highest risk are those living in
endemic areas (hot and moist) with
poor conditions such as inadequate
bedding, contaminated water, and
insufficient diet, or other diseases that
compromise immune function.
 Acc to WHO- India, Brazil, Indonesia,
Myanmar and Nigeria are with the most
cases.

10. Classification
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 Main 2 types:
 Tuberculoid type: highresistance.
 Lepromatous or low resistance
 Cass not falling in these 2 are
considered as borderline leprosy.

11. Classification
Based on the clinical, bacteriologic, immunologic and
histopathologic features, leprosy is classified into main
types:
1. Paucibacillary example: (Tuberculoid leprosy) (TL)
(with scanty or absent bacilli) - Skin lesions, loss
of sensation.
2. Multibacillary (Border line) (with numerous
bacilli)---numerous skin lesions, loss of sensation,
can go to
3. Multibacillary (lepromatous leprosy) (LL).
Nodules and plaques, thickened dermis, loss of
sensation, neuronal damage, nasal congestion,
epistaxis.
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12. Symptoms
 Leprosy attacks the nervous system, particularly the
nerves of the hands, feet and face.
 In tuberculoid leprosy, skin lesions typically develop in
areas of nerve damage. Skin becomes pale, may develop a
reddish copper colour.
 Lepromatous leprosy: Loss of sensation to pin- prick or
light touch. Starts at the fingers and toes, affect a small
patch of skin to begin with, but as time passes many
skin lesions and nodules develop organdeformities.
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13. The bacilli are usually absent in slit-
skin smears.
The histopathology shows tuberculoid
granulomas composed of epithelioid
cells surrounded by a zone of
lymphocytes.
Lepromin test is strongly positive.
Tuberculoid Leprosy
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Tuberculoid Leprosy

15. Lepromatous Laprosy Cutaneous lesions
consist of macules, papules, infiltration or nodules
(lepromas).
• They are numerous, bilateral, symmetrical,
ill-defined with shiny surface.
• The sites commonly affected are the face,
arms, legs and buttocks, but may be anywhere.
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17. Diagnosis
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1. Clinical symptom diagnosis:
(anesthesia, nerve enlargement, and
characteristic skin lesions).
2. Slit-skin smears: Ziehl Neelson staining of
skin smear.
3. Skin biopsy. 4.
Nerve biopsy.
5. Lepromin test.

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1. Clinical symptom diagnosis

19. 2. Skin Smear Tests
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Ziehl Neelsen Carbol Fuchsin Stain (ZNCF)
Absence of bacteria in smear: Paucibacillary
Presence of bacteria in smear: Multibacillary

20. 3. Lepromin test
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It is an immunologic test indicative of host resistance to
M. leprae.
A sample of inactivated (unable to cause infection) leprosy-
causing bacteria is injected just under the skin, usually on the
forearm
Tuberculoid: The immune system recognizes and
produces allergic reaction: Positive
Lepromatous:The immune system does not recognizes
Negative

21. Mechanism of Nerve Damage
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Entry Through Blood Vessels
Inflammatory Response
Demyelination

22.  Sensory Loss
 Paralysis
 Deformities
Outcomes of Nerve Damage
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23. Classification of Drugs
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Sulfones: Dapsone (weak bactericidal)
MDT: Dapsone + Clofazimine + Rifampicin
Antibiotics: Ofloxacin,Clarithromycin, Minocyclin

24. 1995:WHO Distributes MDT Drugs for Free
to WorldwidePatients
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World leprosy day January 30 in remembrance of

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