More than 16 million patients throughout the world have been treated for leprosy in the last 20 years, with 211,973 new cases occurring in 2015, accounting for 2.9 new cases per 10,000 people. These new cases indicate the transmission continuity of the disease, of which 94% were registered in only 13 countries (Bangladesh, Brazil, Democratic Republic of Congo, Ethiopia, India, Indonesia, Madagascar, Myanmar, Nepal, Nigeria, Philippines, Sri Lanka And the United Republic of Tanzania) Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes The Ridley-Jopling system classifies leprosy as: Tuberculoid leprosy Lepromatous leprosy Borderline tuberculoid leprosy Borderline leprosy Borderline lepromatous leprosy   WHO classification (1982) is more of a therapeutic classification based on number of skin lesions present: Paucibacillary group (PB) exhibits 1–5 skin lesions. Multibacillary type (MB) involves more than 6 skin lesions. The Indian classification was modified and accepted by the Indian Association of Leprologists in 1981: Tuberculoid Borderline Lepromatous Indeterminate Pure neuritic. Signs and symptoms The disease can cause skin symptoms such as: Discolored patches of skin, usually flat, that may be numb and look faded (lighter than the skin around) Growths (nodules) on the skin Thick, stiff or dry skin Painless ulcers on the soles of feet Painless swelling or lumps on the face or earlobes Loss of eyebrows or eyelashes Numbness of affected areas of the skin Muscle weakness or paralysis (especially in the hands and feet) Enlarged nerves (especially those around the elbow and knee and in the sides of the neck) Eye problems that may lead to blindness (when facial nerves are affected). Symptoms caused by the disease in the mucous membranes are: A stuffy nose Nosebleeds If left untreated, the signs of advanced leprosy can include: Paralysis and crippling of hands and feet Shortening of toes and fingers due to reabsorption Chronic non-healing ulcers on the bottoms of the feet Blindness Loss of eyebrows Nose disfigurement Other complications that may sometimes occur are: Painful or tender nerves Redness and pain around the affected area Burning sensation in the skin Histopathologic examination of skin biopsies confirm diagnosis of leprosy classification of leprosy. Bacteriological Examination Skin smears: Smears taken from the lesions ,from ear lobules and eyebrows and are stained using modified zeihl-neelsen method. Reading of smears: Bacteriological index- Indicates density of leprosy bacilli (live & dead) in the smears and ranges from 0 to 6+ Morphological index- It is the percentage of presumably living bacilli in relation to total number of bacilli in  the smear Lepromin test Immunological test indicative of host resistance to lepra bacilli.

1. LEPROSY
PRESENTED BY: NAINA JOSHI
MPT 2ND YEAR

2. INTRODUCTION
 More than 16 million patients throughout the world have been
treated for leprosy in the last 20 years, with 211,973 new
cases occurring in 2015, accounting for 2.9 new cases per
10,000 people.
 These new cases indicate the transmission continuity of the
disease, of which 94% were registered in only 13 countries
(Bangladesh, Brazil, Democratic Republic of Congo, Ethiopia,
India, Indonesia, Madagascar, Myanmar, Nepal, Nigeria,
Philippines, Sri Lanka And the United Republic of Tanzania)
 Cláudia Cecília et al. Leprosy and Physiotherapy: a necessary
approach. J Hum Growth Dev. 2019; 29(3):416-426

3. definition
 Leprosy is a chronic infectious disease caused
by Mycobacterium leprae, an acid-fast, rod-shaped bacillus.
The disease mainly affects the skin, the peripheral nerves,
mucosa of the upper respiratory tract, and the eyes

4. classification
 The Ridley-Jopling system classifies leprosy as:
1. Tuberculoid leprosy
2. Lepromatous leprosy
3. Borderline tuberculoid leprosy
4. Borderline leprosy
5. Borderline lepromatous leprosy

5.  WHO classification (1982) is more of a therapeutic classification based on
number of skin lesions present:
1. Paucibacillary group (PB) exhibits 1–5 skin lesions.
2. Multibacillary type (MB) involves more than 6 skin lesions.
 The Indian classification was modified and accepted by the Indian Association of
Leprologists in 1981:
1. Tuberculoid
2. Borderline
3. Lepromatous
4. Indeterminate
5. Pure neuritic.

6. Signs and symptoms
 The disease can cause skin symptoms such as:
• Discolored patches of skin, usually flat, that may be numb and look faded
(lighter than the skin around)
• Growths (nodules) on the skin
• Thick, stiff or dry skin
• Painless ulcers on the soles of feet
• Painless swelling or lumps on the face or earlobes
• Loss of eyebrows or eyelashes

7.  Symptoms caused by damage to the nerves are:
• Numbness of affected areas of the skin
• Muscle weakness or paralysis (especially in the hands and feet)
• Enlarged nerves (especially those around the elbow and knee and in the sides
of the neck)
• Eye problems that may lead to blindness (when facial nerves are affected).
 Symptoms caused by the disease in the mucous membranes are:
• A stuffy nose
• Nosebleeds

9.  If left untreated, the signs of advanced leprosy can include:
• Paralysis and crippling of hands and feet
• Shortening of toes and fingers due to reabsorption
• Chronic non-healing ulcers on the bottoms of the feet
• Blindness
• Loss of eyebrows
• Nose disfigurement
 Other complications that may sometimes occur are:
• Painful or tender nerves
• Redness and pain around the affected area
• Burning sensation in the skin

11. DIAGNOSTIC PROCEDURE
1. Histopathologic examination of skin biopsies
•confirm diagnosis of leprosy
•classification of leprosy.
2.Bacteriological Examination
•Skin smears:
•Smears taken from the lesions ,from ear lobules and eyebrows and are stained using modified zeihl-
neelsen method.
•Reading of smears:
•Bacteriological index- Indicates density of leprosy bacilli (live & dead) in the smears and ranges from 0 to 6+
•Morphological index- It is the percentage of presumably living bacilli in relation to total number of bacilli in the
smear
3.Lepromin test
Immunological test indicative of host resistance to lepra bacilli. A sample of inactivated leprosy causing bacteria is
injected just under the skin ,usually on the forearm.
•Tuberculoid-immune system recognizes and produces allergic reactions: positive
•Lepromatous-the immune system does not recognizes: negative
4.Polymerase chain reaction
•for detection of M. lepra DNA in tissue.