Leprosy - Part 1 - a presentation at

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LEPROSY

PART 1

Pradnya Gogate B. Optom,

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LEPROSY

Hansen’s disease

Chronic, granulomatous Etiology: Mycobacterium leprae Male: Female ratio –2:1 Transmission in nasal discharge, contact

CLASSIFICATION

Tuberculoid

Lepromatous

Borderline/ Dimorphous

TUBERCULOID Benign Distribution: Face, skin, gluteal region,

limbs Asymmetrical lesions, anhydrotic Polyneuritis Claw hand, foot drop Nerves involved Eg. Ulnar, peroneal Loss of sensation

LEPROMATOUS Macular, diffuse nodular Distribution: Face, ear lobes, neck, extremities,

Borderline

Intermediate between lepromatous & tuberculoid Bizarre skin lesions (eyes, nose)

LEPRA REACTIONS

Inflammation in pre-existing lesions Type I: Borderline & tuberculoid Mechanism: Cell mediated

hypersensitivity Occurs spontaneously, loss of nerve

function, swollen skin lesions Type II: Common in 2nd year of treatment Fever, painful papules/nodules(erythema

nodosum leprosum)

OCULAR FEATURES

Conjunctivitis Keratitis Loss of eyelash/ eyebrows Scleritis Corneal anaesthesia Iritis (lepromatous) Severe miosis, iris atrophy

LEPROMATOUS IRITIS

INVESTIGATIONS

Slit skin smear: Lesions from ear lobe, ring/middle finger

Lepromin test (suspension of dead M.leprae) Classify disease, determine

prognosis/treatment

MANAGEMENT

Isolation of patient till non-infectious Three drug therapy: Rifampicin Clofazimine 50mg/day Dapsone 2mg/kg/day Chemotherapy for lepra reactions:

Thalidomide 100mg/6hrs Aspirin 600mg/6hrs Steroids

PREVENTION

Avoid contact

Regular treatment

Follow up

Improve socio-economic conditions

CONTINUE TO PART II …

THANK YOU

Health & Medicine