Symptoms Of Leprosy

Leprosy or Hansen’s disease is caused by M. leprae bacteria. It was prevalent at one time, but now it is noted, as a rare occurrence. In 2010 294 cases were reported in the United States alone, which was also noted as affecting more males (199) than females (HRSA). Leprosy is characterized by skin lesions (sores) and nerve damage.

Types of Leprosy

  • Tuberculoid – affects the skin only, few lesions are noted, with the immune system being strong and healthy
  • Lepromatous – affects the skin, nerves, and other organs. Skin lesions and nodules or growths underneath the skin. These nodules will be filled with inflamed tissue and fluid. This type of Leprosy is known for being highly contagious.
skin lesions of leprosy
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Leprosy Categories

Medical professionals have categorized Leprosy, by how much of the skin tissue is affected and the type.

  • Paucibacillary – tissue samples will reveal no signs of bacterial infection and 0-5 skin lesions are noted.
  • Multibacillary – tissue samples will reveal signs of bacterial infection, with 5 or more skin lesions being noted.

Incubation Period

The incubation period is noted, as being the time of the exposure to the M. leprae bacteria and when the symptoms first appear. M. leprae is a very slow multiplying and growing bacteria. Noted cases have shown that the victim may be asymptomatic for up to 5-20 years, after the time of exposure (WHO).

Ridley-Jopling System

This Leprosy classification system is used, as a global tool to classify the severity of the symptoms. It is based on previous clinical studies of the disease.

  • Intermediate – only a few flat skin lesions will be noted. Can potentially heal itself, without treatment, but also has the possibility to develop into a more severe type of Leprosy.
  • Tuberculoid – only a few flat, large, and calloused skin lesions are noted. Nerve involvement is also noted, in this form of Leprosy, with the possibility of it healing itself, without treatment or can progress to a more severe type.
  • Borderline Tuberculoid – small and fewer skin lesions are noted, with peripheral nerve involvement. Has the potentiality to development into Tuberculoid or another Leprosy type.
  • Mid-Borderline – reddish, calloused skin lesions may be noted, with nearby lymph node involvement.
  • Lepromatous – bacterial skin lesions, hair loss, nerve involvement, muscle weakness, and deformities are noted. This type of Leprosy has a poor prognosis, especially, when deformities are noted.

Mode of Transmission

Leprosy is spread through droplets. You must be within 3 feet of the droplets to come into contact with it. Respiratory droplets are formed by sneezing, coughing, exhale, or drip. Droplets are heavy, so they are not capable of staying suspended in air for long periods of time. If you know someone that has been diagnosed with Leprosy, you should always wear a respiratory mask, when coming into contact with  them.

Diagnosis

  • Skin Biopsy
  • Lepromin Skin Test (an intradermal injection, in which inactivated M. leprae is injected into the skin). This test is administered in the same fashion, as a TB skin test, with potentially the same results being expected. The injection site will be examined on the 3rd and 28th day, post testing. This test is only capable of diagnosing borderline tuberculoid and tuberculoid. If the test is positive, a small lump will appear on the skin, at the injection site.

Symptoms

  • Muscle weakness
  • Non-healing skin lesions that are pale in color, warm to touch, and painful
  • Paresthesia (numbness in fingers, arms, feet, and legs)
  • Paralysis (if left untreated)
  • Alopecia (hair loss, but mostly noted on the eyebrows and lashes)
  • Glaucoma
  • Erectile dysfunction
  • Renal failure
  • Iritis (inflammation of the iris)
Leprosy With Deformities
 

Treatment

  • Ofloxacin (quinolone antibiotic that is often used to treat optic bacterial infections)
  • Minocycline (broad spectrum, tetracycline antibiotic)
  • Rifampin(rifamycin antibiotic that is often prescribed for TB)
  • Dapsone (used in conjunction with Rifampin)

Prognosis

Prognosis is fairly good, if caught in the early stages of the disease. If paralysis or deformities are noted, the prognosis is potentially poor.