Leprosy

Leprosy:

Bacterial disease caused by Mycobacterium leprae affecting mainly the skin and peripheral nerves

Classification:

A.WHO classification according to treatment:

1. Paucibacillary: Bacillary load is low,skin smear is negative,number of skin lesion 1-2,nerve and skin lesion maximum upto 9
2. Multibacillary: Bacillary load high,skin smear positive,number of skin and nerve lesion 10 or more

B.According to spectrum of leprosy:

1. Intermediate leprosy(I)
2. Tubercular leprosy(TL)
3. Borderline leprosy(BT)
4. Midborderline leprosy(BB)
5. Borderline lepromatous(BL)
6. Lepromatus leprosy(LL)
7. Primary neurotic leprosy(PN)

Clinical features:

1. Hypopigmentation/Erythematous skin lesion
2. Sensation lost:cold-light touch,pain-deep touch
3. Thickening of nerve:ulner nerve,radial nerve
4. Infiltration
5. Nodules
6. Ulcers
7. Madarosis(2yrs):loss of eyebrow
8. Collapse of nose(3-4yrs):due to nasal cyst formation
9. Leionine facies
10. Loss of sweating and hair loss

Treatment of leprosy:

1.Paucibacillary :
a)Rifampicin:600mg monthly for 6 month
b)Dapsone:100mg daily for 6 months

2.Multibacillary:
a)Rifampicin:600mg monthly for 2 years
b)Dapsone:100mg daily for 2 years
c)Clofazimine:300mg monthly or 50mg daily for 2 years

DOT:Directly observed treatment