This document provides an overview of leprosy (Hansen's disease). It discusses the causes (Mycobacterium leprae bacteria), classification (tuberculoid, borderline, lepromatous types), symptoms, risks, and global situation. It describes the standard treatment as multidrug therapy including dapsone, rifampicin, and clofazimine. Side effects and the dosage regimens for each drug class are outlined. Traditional and alternative treatments like chaulmoogra oil are also mentioned. The document concludes with references.

1. Leprosy
(Hansen’s Disease)
By
N.SRAVANTHI REDDY (O9DH1ROO34)
Under the supervision of
K.RAMANJANEYULU(Ph.D)
Dept of pharmaceutical
chemistry
VIPER

2. Contents
leprosy
Causes
Classification
Symptoms
Risks
Treatment(chemotherapy)
Dosage
Adverse effects
Global situation
R & D
References

3. What is Leprosy?
Chronic infectious disease.
World's oldest recorded disease ( 600B.C )
was well-recognized in the civilizations of
ancient China, Egypt, and India.
Gerhard Armauer Hansen
Every year January 27 is World Leprosy Day

4. CausesCauses
Mycobacterium leprae
Rod Shaped
First bacterium disease in
humans
Humans and Armadillos are
only known natural hosts
M. leprae appear red when a
Ziehl-Neelsen stain is used,helps in finding

5. Classification
 Tuberculoid Leprosy (TL)
 Borderline Tuberculoid Leprosy (BT)
 Borderline borderline Leprosy (BB)
 Borderline lepromatous Leprosy (BL)
 Lepromatous leprosy(LL)

6. BASED ON SIZE :
Paucibacillary Leprosy (PB) : skin lesions with
no bacilli(M.Leprae) seen in the skin smear
Multibacillary Leprosy (MB): skin lesions with
bacilli (M.Leprae)seen in the skin smear

7. Tuberculoid leprosy:
Can be either one large red patch with well-defined raised
borders or a large hypopigmented asymmetrical spot
Lesions become dry and hairless
Loss of sensation may occur at site of some lesions
Enlargement of nerves with subsequent loss of function are
common
Spontaneous resolution may occur in a few years or it may
progress to borderline or rarely lepromatous types

8. Borderline
tuberculoid
Similar to tuberculoid
type except that lesions
are smaller and more
numerous
Disease may stay in this
stage or convert back to
tuberculoid form, or
progress
Borderline
borderline
Numerous, red,
irregularly shaped plaques
Sensory loss is moderate
Disease may stay in this
stage, improve or worsen

9. Numerous lesions of all kinds, plaques, macules,
papules and nodules. Lesions looking like inverted
saucers are common
Hair growth and sensation are usually not impaired
over the lesions
Borderline lepromatous

10. Numerous lesions of all kinds,
plaques, macules, papules and
nodules
Early symptoms include nasal
stuffiness, discharge and
bleeding, and swelling of the
legs and ankles
Lepromatous leprosy

11. Left untreated, the following problems may occur:
Skin thickens over forehead (leonine facies), eyebrows and
eyelashes are lost, nose becomes misshapen or collapses,
ear lobes thicken, upper incisor teeth fall out
Eye involvement causing photophobia (light sensitivity),
glaucoma and blindness
Skin on legs thickens and forms ulcers when nodules break
down
Internal organ infection causing enlarged liver and lymph
nodes
Voice becomes hoarse

12. What are the symptoms?
Paucibacillary (PB) Leprosy
symptoms are:
Well defined skin lesions that are
numb
Multibacillary (MB) Leprosy
symptoms are:
– Chronically stuffy nose and many skin
lesions and nodules on both sides of the
body
• Mycobacterium leprare multiplies very slowly
• Symptoms can take as long as 20 years to appear

13. Who is at risk?
Mainly affects:
Skin
Eyes
The peripheral nerves
Mucosa of the upper
respiratory tract
• It can affect all ages and both sexes

14. Who is at risk?
A 24-year-old man
infected with leprosy

15. Pharmaceutical Treatment
Multiple Drug Treatment (MDT)
• Effective chemotherapeutic agents:
Dapsone (diamino diphenyl sulfone,
DDS) which was discovered in early
1940’s
Rifampicin (RFP), Clofazimine (CLF)
discovered in 1960’s
Ofloxacin (OFLX), and Minocycline
(MINO) constitute the backbone of the
multidrug therapy (MDT) regimen.

16. Structure of Dapsone (DDS)
http://images.google.com/imgres?imgurl=http://upload.wikimedia.org/wikipedia/commons/thumb/c/c2/Dapsone.svg/671px-
Dapsone.svg.png&imgrefurl=http://commons.wikimedia.org/wiki/Image:Dapsone.svg&h=290&w=671&sz=11&hl=en&start=13&um=1&tbnid=ihM5GO42l13LYM:&tbnh=60&tbnw=138&pre
v=/images%3Fq%3Ddapsone%26um%3D1%26hl%3Den

17. About Dapsone
It was dicovered by German chemists Fromm
and Wittmann in 1908
Was not utilized as a treatment until decades
later
Available in 25mg & 100 mg tablets
Rated a pregnancy risk category C by the
American Food and Drug Administration

18. About Rifampicin
In the U.S. Rifampicin is marketed
as:
Rifadin (Aventis)
Rifater ( in combination with
isoniazid and pyrazinamide)
(Aventis)
Rimactane (Novartis)
Rated a pregnancy risk category C
by the American Food and Drug
Administration

19. About Clofazimine
Brand Name: Lamprene
Generic Name: Clofazimine
Initially known as B663, was first synthesized in
1954 by Dr. Vincent Barry and his team as an
anti-tuberculosis drug
Is marketed under the trade name Lamprene®
by Novartis

20. Dosage
http://images.google.com/imgres?imgurl=http://upload.wikimedia.org/wikipedia/commons/thumb/7/71/MDTRegimens.jpg/400px-
MDTRegimens.jpg&imgrefurl=http://en.wikipedia.org/wiki/Leprosy&h=258&w=400&sz=24&hl=en&start=15&um=1&tbnid=wA9E8CWvT_HvoM:&tbnh=80&tbnw=124&prev=/images%3Fq%3DMultidrug%2Btherapy%2B(MDT)
%2Bregimen%26um%3D1%26hl%3Den

21. Dosage Cont’d......
RFP Dapsone
Adult
50-70kg
600mg/m* 100mg/d
Child
10-14 years
450mg/m* 50mg/d
Less than 10
years
300mg/m* 25mg/d
Multidrug Therapy for Paucibacillary (PB) Leprosy
PB patients treated with MDT are cured within six
months
*RFP monthly doses are given under supervision

22. Dosage Cont’d......
RFP Dapso
ne
CLF
Adult
50-70kg
600mg/m
*
100mg
/d
50mg/d
&300mg/m*
Child
10-14
years
450mg/m
*
50mg/
d
50mg/d
&150mg/m*
Less than
10 years
300mg/m
*
25mg/
d
50mg
twice/d
&100mg/m*
Multidrug Therapy for Multibacillary (MB) Leprosy
*RFP and CLF monthly doses are given under supervision
MB patients treated with MDT are cured within 12 months

23. Cost of MDT
Since 1995, WHO has supplied MDT FREE of cost to all
leprosy patients in the world.
Initially drug funds were provided by Nippon Foundation
Since 2000, donations are provided by Novartis and the
Novartis Foundation for Sustainable Development

24. Side Effects
Dapsone (DDS)
Rifampicin (RFP)
Clofazimine (CLF)
Occasional cutaneous
eruptions
A slight reddish coloration of
urine, sweat, and tears
Brownish Black discoloration
and dryness of skin

25. Cases around the World
A 20% annual decrease in new cases detected globally since 2001.
the disease has been eliminated from 108 out of 122.

26. A Day in the Patient’s Life
AN AFFECTIONATE HAND FOR THE NEEDY……….
http://i193.photobucket.com/albums/z96/whengzky/FR%20Joy%20pix/641c.jpg

27. JALANETI:
Technique related to yoga.
It is the best remedy for nasal stiffness.
Normal saline is passed through one nostril and is
collected from other , which flushes the micro
organisms.

28. The disease was known in Ancient Greece as elephantiasis
A common pre-modern treatment of leprosy
was chaulmoogra oil.
The oil has long been used in India as an
Ayurvedic medicine for the treatment of leprosy
and various skin conditions.
It has also been used in China and Burma, and
was introduced to the West by Frederic John , a
professor at Bengal Medical CollegeBengal Medical College.
 He tried the oil as an oral and topical agent in
two cases of leprosy and reported significant
improvements in an 1854 paper.

29. REFERENCES:
 Sasaki S, Takeshita F, Okuda K, Ishii N (2001). "Mycobacterium leprae and leprosy: a compendium"
. Microbiol Immunol 45 (11): 729–36. PMID 11791665.
http://www.jstage.jst.go.jp/article/mandi/45/11/729/_pdf. ^ a b c
"New Leprosy Bacterium: Scientists Use Genetic Fingerprint To Nail 'Killing Organism'".
ScienceDaily. 2008-11-28. http://www.sciencedaily.com/releases/2008/11/081124141047.htm.
Retrieved 2010-01-31. ^ a b c
Kenneth J. Ryan, C. George Ray, editors. (2004). Ryan KJ, Ray CG. ed.
Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 451–3. ISBN 0838585299. OCLC
61405904 52358530 61405904. ^ a b
"Lifting the stigma of leprosy: a new vaccine offers hope against an ancient disease". Time 119 (19):
87. May 1982. PMID 10255067.
http://www.time.com/time/magazine/article/0,9171,925377,00.html. ^ Kulkarni GS (2008).
Textbook of Orthopedics and Trauma (2 ed.). Jaypee Brothers Publishers. p. 779. ISBN 8184482426,
9788184482423. ^ "Q and A about leprosy". American Leprosy Missions.
http://www.leprosy.org/getinformed/aboutleprosy/leprosyfaq.php. Retrieved 2011-01-22.17 - PRABHAKAR, M.C.; APPA RAO, A.V.N.; KRISHNA,
D.R.; RAMANAKAR, T.V. How much noninfectious
are the
"non-infectious" lepromatous leprosy patients?
Leprosy- India, 55(3): 576-583, 1983.
ESSENTIALS OF MEDICAL PHARMACOLOGY BY K.D.TRIPATHI.