Clarinda clare linusDiploma in Medical Science Intake January 2011 Lecturer : DR. Angelo
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.
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.
Mycobacterium leprae - Gram-positive,rod prokaryote (dividing), cause of leprosy (Hansens disease)Slow growing, rod shape bacillusFirst infectious bacteria discovered toCause disease in human
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
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. Leprosys long incubation period makes it very difficult for doctors to determine when and where a person with leprosy originally got sick.
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.
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.
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
Procedure to Lepromin Skin TestA tiny sample of leprosy antigen is injected under theskin, usually in the forearm. The skin gets pushedup, forming a small bump. This is an indication that theantigen has been injected to the correct depth. The site ofthe injection is marked, and is examined for reaction, firstafter 3 days and then again after 28 days.Post Lepromin Skin TestThere may be a slight burning or stinging sensation. Somemay also experience a slight itching at the injection siteafter a few days. There is usually no risk involved, and it isonly in rare cases that an allergy in the form of hives mayappear.
A skin lesion biopsy is the removal of a piece of skin to diagnose or rule out an illness.
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 physicians office, and results are often available in 4 to 10 days. It is commonly performed by dermatologists
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
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.
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.
Avoid close physical contact with untreated people. People on long-term medication become noninfectious (they do not transmit the organism that causes the disease).