SPOTTERS MEDICINE
LEPROSY
🔹 Definition:
Leprosy is a
chronic infectious disease caused by Mycobacterium leprae,
primarily affecting the skin, peripheral nerves, mucosa of upper respiratory
tract, and eyes.
🔹 Causative Organism:
- Mycobacterium leprae – acid-fast, slow-growing
bacillus
- Cannot be cultured in vitro (only in mouse footpad and
armadillo)
🔹 Mode of Transmission:
- Prolonged close contact with untreated cases
- Spread via nasal droplets or
skin contact
- Incubation period: 2 to 20
years
🔹 Classification (Ridley-Jopling
Spectrum):
1.
Tuberculoid (TT) – Strong immunity, localized lesions
2.
Borderline tuberculoid (BT)
3.
Mid-borderline (BB)
4.
Borderline lepromatous (BL)
5.
Lepromatous (LL) – Poor immunity, widespread lesions
WHO
Classification (for treatment):
- Paucibacillary (PB): ≤5 skin lesions, no bacilli on
smear
- Multibacillary (MB): >5 lesions or bacilli on
smear
🔹 Clinical Features:
- Hypopigmented or reddish skin
patches with loss
of sensation
- Thickened peripheral nerves (e.g., ulnar, common peroneal)
- Muscle weakness, deformities (claw hand, foot drop)
- Nasal stuffiness, eye
complications
in LL cases
🔹 Diagnosis:
- Clinical signs: anesthetic patches, nerve
thickening
- Skin smear (acid-fast bacilli)
- Skin biopsy – granulomas or foamy
macrophages
- Lepromin test – for immune status (not
diagnostic)
🔹 Complications:
- Nerve damage → deformities
- Blindness, trophic ulcers,
secondary infections
- Type 1 & Type 2 lepra
reactions
🔹 Treatment (WHO MDT Regimen):
Paucibacillary
(PB):
- Rifampicin 600 mg once monthly
(supervised)
- Dapsone 100 mg daily
(self-administered)
- Duration: 6 months
Multibacillary
(MB):
- Rifampicin + Dapsone +
Clofazimine
- Duration: 12 months
🔹 Prevention and Control:
- Early case detection and
treatment
- Contact tracing
- BCG vaccination gives partial protection
- Disability prevention and
rehabilitation
🔹 Prognosis:
- Excellent with early diagnosis
and full MDT course
- Permanent disability if
diagnosis is delayed
DR.C.GANESAN M.D.
PROFESSOR OF MEDICINE
No comments:
Post a Comment