LEPROSYClarinda clare linus

Diploma in Medical ScienceIntake 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.

epidemiology

LEPROSY

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.

Causes

Mycobacterium leprae

Mycobacterium leprae - Gram-positive, rod prokaryote (dividing), cause of leprosy (Hansen's disease)

Slow growing, rod shape bacillus

First infectious bacteria discovered toCause disease in human

MORPHOLOGY

Leprosy damage nerves Earlobe

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

Symtomps

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.  Leprosy's long incubation period makes it very difficult for doctors to determine when and where a person with leprosy originally got sick.

Symtomps

The cardinal manifestations of leprosy are infiltrative skin lesions, hypoesthesia, and peripheral neuropathyThe clinical manifestations of leprosy are closely related to the polarity of the cellular immune response to M. leprae in the patient.

Clinical Manifestation

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

Diagnosis

Procedure to Lepromin Skin Test

A tiny sample of leprosy antigen is injected under the skin, usually in the forearm. The skin gets pushed up, forming a small bump. This is an indication that the antigen has been injected to the correct depth.  The site of the injection is marked, and is examined for reaction, first after 3 days and then again after 28 days.

Post Lepromin Skin Test

There may be a slight burning or stinging sensation. Some may also experience a slight itching at the injection site after a few days. There is usually no risk involved, and it is only in rare cases that an allergy in the form of hives may appear.

Lepromin Skin Test

A skin lesion biopsy is the removal of a piece of skin to diagnose or rule out an illness.

Skin lesion biopsy

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 physician's office, and results are often available in 4 to 10 days. It is commonly performed by dermatologists

Skin lesion biopsy

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

Skin scraping

Skin scraping

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.

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.

Complication

Avoid close physical contact with untreated people. People on long-term medication become noninfectious (they do not transmit the organism that causes the disease).

Prevention

www.ncbi.nlm.nih.gov http://en.wikipedia.org/wiki/Skin_biopsy http://www.ncbi.nlm.nih.gov/pubmedhealth/

PMH0002323/#adam_001347.disease.causes

References

THANK YOUSALAMAT PO!