Leprosy is a chronic infectious disease caused by the bacterium Mycobacterium leprae. It primarily affects the skin and peripheral nerves and can cause disfigurement if untreated. Symptoms include light-colored skin lesions with reduced sensation, muscle weakness, and numbness in the hands, feet and limbs. Diagnosis involves examination of skin lesions, scrapings, and biopsies. Treatment consists of long-term courses of antibiotics like dapsone or clofazimine to control the bacteria and relieve symptoms.

1. Clarinda clare linus
Diploma in Medical Science
Intake January 2011
Lecturer : DR. Angelo

2.  Leprosy is a disease that has been known since
biblical times. It causes skin sores, nerve
damage, and muscle weakness that gets worse
over time.
 It is also known as Hansen’s disease.
Its main features are skin sores which cause
severe disfigurement. This is also accompanied
by peripheral nerve damage (damage of the
nerves in the legs and arms), which leads to loss
of sensation in the skin. Those affected by
leprosy also suffer from muscle weakness which
leads to progressive debilitation.

4. bacterium Mycobacterium leprae
- It is not very contagious and it has a long
incubation period (time before symptoms
appear), which makes it hard to know where
or when someone caught the disease.
The disease is spread in humans by droplets of
nasal mucus and a person is infectious only
during the first stages of leprosy.

5. Mycobacterium leprae - Gram-positive,
rod prokaryote (dividing), cause of leprosy
(Hansen's disease)
Slow growing, rod shape bacillus
First infectious bacteria discovered to
Cause disease in human

6. Leprosy damage nerves Earlobe

7.  Symptoms include:
 Skin lesions that are lighter than your normal
skin color
◦ Lesions have decreased sensation to touch, heat, or
pain
◦ Lesions do not heal after several weeks to months
 Muscle weakness
 Numbness or lack of feeling in the
hands, arms, feet, and legs

8.  It takes a very long time for symptoms to appear
after coming into contact with the leprosy-
causing bacteria. Some people do not develop
symptoms until 20 or more years later.
 The time between contact with the bacteria and
the appearance of symptoms is called the
incubation period. Leprosy's long incubation
period makes it very difficult for doctors to
determine when and where a person with leprosy
originally got sick.

9. The cardinal manifestations of leprosy are
infiltrative skin lesions, hypoesthesia, and
peripheral neuropathy
The clinical manifestations of leprosy are
closely related to the polarity of the cellular
immune response to M. leprae in the patient.

10. The history of a patient with suspected leprosy
should include whether the person has resided in
an area with high prevalence and whether the
person has been previously diagnosed or treated
for leprosy.
Certain patients may deny knowledge of a prior
diagnosis or may report that skin lesions or
neuropathy or both are acute, as they wish to
avoid the stigma of a diagnosis of leprosy, even
in emigrants to developed countries.

11.  Lepromin skin test can be used to tell the two
different forms of leprosy apart, but it is not
used to diagnose the disease
 Skin lesion biopsy
 Skin scraping examination

12. Procedure to Lepromin Skin Test
A tiny sample of leprosy antigen is injected under the
skin, usually in the forearm. The skin gets pushed
up, forming a small bump. This is an indication that the
antigen has been injected to the correct depth. The site of
the injection is marked, and is examined for reaction, first
after 3 days and then again after 28 days.
Post Lepromin Skin Test
There may be a slight burning or stinging sensation. Some
may also experience a slight itching at the injection site
after a few days. There is usually no risk involved, and it is
only in rare cases that an allergy in the form of hives may
appear.

13.  A skin lesion biopsy is the removal of a piece
of skin to diagnose or rule out an illness.

14.  Skin biopsy is a biopsy technique in which a
skin lesion is removed to be sent to a
pathologist to render a microscopic
diagnosis.
 It is usually done under local anesthetic in a
physician's office, and results are often
available in 4 to 10 days. It is commonly
performed by dermatologists

15.  Skin scraping is a bedrock technique in dermatology
that is applied in a high proportion of cases.
 It enables both the full thickness of the epidermis
and the contents of the hair follicles to be sampled
 It is most commonly used in the diagnosis of
parasitic infestations such as sarcoptic
mange, cheyletiellosis and demodicosis
 Generally several sites are sampled. Mites can be very
difficult to find in some cases

17.  ANTIBIOTICS
 antibiotics (such as dapsone or clofazimine) are
typically used, as is supportive care, which helps
to relieve symptoms and complications.
 Because Mycobacterium leprae (the bacteria that
causes leprosy) can be resistant to certain
antibiotics, several antibiotics are typically
combined for treatment.

18.  Disfigurement
 Muscle weakness
 Permanent nerve damage in the arms and
legs
 Sensory loss
 People with long-term leprosy may lose the
use of their hands or feet due to repeated
injury because they lack feeling in those
areas.

19.  Avoid close physical contact with untreated
people. People on long-term medication
become noninfectious (they do not transmit
the organism that causes the disease).

20.  www.ncbi.nlm.nih.gov
 http://en.wikipedia.org/wiki/Skin_biopsy
 http://www.ncbi.nlm.nih.gov/pubmedhealth/
PMH0002323/#adam_001347.disease.causes