3. Leprosy
Leprosy is an infectious disease that causes severe,
disfiguring skin sores, and nerve damage in the arms and
legs.
It is caused by a slow-growing type of bacteria called
Mycobacterium leprae .
Leprosy is also known as Hansen's disease, after the
scientist who discovered M. leprae in 1873.
The social and psychological effects of leprosy, as well as
its highly visible debilities, have resulted in a historical
stigma associated with leprosy.
4. Epidemiology
Every year, around 250,000 new leprosy
cases are identified; out of these, 60% are in
India. About 133,717 new cases of leprosy
have been reported during 2009-2010.
This substantial decrease is largely due to
the effectiveness of multidrug therapy
(MDT).
5. Pathophysiology
Leprosy is defined by the number and type of skin
sores.
Specific symptoms and treatment depend on the
type of leprosy.
The types are as follows:
Intermediate-this type includes early cases with
hypopigmented macules and sensory impairment.
6. Pathophysiology
Tuberculoid -a mild, less severe form of leprosy.
People with this type have only one or a few
patches of fat, pale- colored skin (paucibacillary
leprosy).
The affected area of skin may feel numb because
of nerve damage underneath.
Tuberculoid leprosy is less contagious than other
forms.
12. Pathophysiology
Lepromatous--it is a more severe form of the
disease. It has widespread skin bumps and rashes
(multibacillary leprosy), numbness, and muscle
weakness.
The nose, kidneys, and male reproductive organs
may also be affected.
It is more contagious than tuberculoid leprosy.
13. Pathophysiology
Borderline--people with this type of leprosy have
symptoms of both the tuberculoid and the
lepromatous forms.
Pure neuritiC -in this type, there is involvement of
nerve but no lesions are present on the skin.
Leprosy can be transmitted from one person to
another through droplet infection, direct contact,
and other routes such as insect vectors, tattooing
needles, and breast milk.
14. Clinical Manifestations
Leprosy primarily affects the skin and the nerves
outside the brain and spinal cord, called the
peripheral nerves.
It may also strike the eyes and the thin tissue lining
the inside of the nose. The main symptom of
leprosy is disfiguring skin sores, lumps, or bumps
that do not go away after several weeks or months.
The skin sores are pale- colored.
15. Clinical Manifestations
Nerve damage can lead to loss of feeling in the
arms and legs, and muscle weakness.
It usually takes about 3-5 years for symptoms to
appear after coming into contact with the leprosy-
causing bacteria. Some people do not develop
symptoms until 20 years later. Leprosy's long
incubation period makes it very difficult to
determine when and where a person with leprosy
got infected.
16. Diagnosis
Diagnosis Leprosy can be diagnosed by proper clinical
examination including health history and physical
examination.
Skin smears, nasal smears, and nasal scrapings are used to
assess for AFB.
Full-thickness biopsies should be taken from an edge of
the lesion that appears most active.
17. Diagnosis
Serological assays and immunological tests can
also be used to diagnose leprosy.
Histamine test can be carried out to detect
peripheral nerve damage at an early stage.
Laboratory tests related to drug treatment follow-
up include CBC count, keratinize level, and liver
function tests.
20. Medical Management
Dapsone remained the choice of drug for the past
30 years or more.
Due to the development of resistance to dapsone ,
the other drugs that were introduced are rifampicin
and clofazimine.
Quinolones, minocycline, and azithromycin have
also proved activity against M. leprae.
21. Medical Management
A single dose of combination therapy has been
used to cure single-lesion paucibacillary leprosy:
rifampicin (600 mg), ofloxacin (400 mg), and
minocycline (100 mg).
Any patient with a positive skin smear must be
treated with the MDT regimen for multibacillary
leprosy.
22. Nursing Management
Have an empathetic attitude and provide social and
psychological support to the patient.
Give prescribed medications.
Provide skin care.
Educate the patient about leprosy.
Prevent disability.
Rehabilitate the patient.
23. REFERENCES
Brunner and Suddarth’s Textbook of Medical- Surgical Nursing
,South Asian
Edition , Volume II , Published by Wolters Kluwer .
Page reffered to 1531- 1532.
https://www.slideshare.net/moliabdu/leprosy-52969449
https://www.slideshare.net/OmVerma6/leprosy-237483809
https://www.leprosy-information.org/media/765/download
