LEPROSY-INTRODUCTON
Leprosy is a chronic infectious disease which attacks the skin, peripheral nerves and mucous membranes. Leprosy is an infectious disease that has been known since biblical times. It may be characterized by disfiguring skin sores, peripheral nerve damage, and progressive debilitation. Leprosy is most common in warm, wet areas in the tropics and subtropics. Leprosy is also called Hansen's disease.
It is caused by the bacteria Mycobacterium leprae.
Leprosy has traditionally been classified into two major types, tuberculoid and lepromatous. Patients with tuberculoid leprosy have limited disease and relatively few bacteria in the skin and nerves, while lepromatous patients have widespread disease and large numbers of bacteria.
Leprosy usually affects the skin and peripheral nerves. However, once a person starts experiencing symptoms, they can range in type and severity. Symptoms can also vary based on the form of leprosy that a person has (tuberculoid leprosy or lepromatous leprosy).
Causes of leprosy:
A bacillus, Mycobacterium leprae, that multiplies very slowly and mainly affects the skin, nerves, and mucous membranes. The organism has never been grown in bacteriologic media or cell culture, but has been grown in mouse foot pads
Contrary to popular belief, leprosy isn’t highly contagious; it actually has a low rate of infectivity.
Transmission of leprosy:
M. leprae is not highly infectious
Transmission is more common among household contacts
Transmission is believed to occur through inhalation of infectious organisms
Transmission through insect bites and inoculation through broken (or intact) skin have not been excluded
Infectious people are thought to shed the organism from the nasal mucous membranes, especially if there is ulceration
M. leprae can survive in nasal secretions for more than 36 hours
Reinfection may account for cases of leprosy in older people
Symptoms of leprosy:
When a person becomes infected with Mycobacterium leprae, the bacteria begin to multiply within the body. After three to five years, leprosy symptoms an begin.
The earliest sign of leprosy is commonly a spot on the skin that may be slightly redder, darker, or lighter than the person's normal skin. The spot may lose feeling and hair. In some people the only sign is numbness in a finger or toe.
Some other symptoms of leprosy are:
1.in lesions that have decreased sensation to touch, heat, or pain and are are lighter than your normal skin color
2.in lesions that do not heal after several weeks to months
3.mbness or absent sensation in the hands and arms, or feet and legs
4.muscle weakness
Treatment of leprosy:
Treatment consists of antimicrobial therapy using sulfones, primarily oral dapsone, which may cause hypersensitivity reactions. Hepatitis and exfoliative dermatitis, although uncommon, are especially dangerous reactions. If they occur, sulfone therapy should be stopped immediately.
Failure to respond to sulfone or the occurrence of respiratory involvement or other complications requires the use of alternative therapy, such as rifampin in combination with clofazimine or ethionamide. Clawhand, wristdrop, or footdrop may require surgical correction.
During the course of treatment, the body may react to the dead bacteria with pain and swelling in the skin and nerves. This is treated with pain medication, prednisone, or thalidomide (under special conditions).
