Leprosy



Overview
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Causes
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    Leprosy is caused by the organism Mycobacterium leprae.
    It is spread when an untreated infected person coughs or sneezes (but not by sexual contact or pregnancy). However, leprosy is not very contagious; approximately 95% of people have natural immunity to the disease. People with leprosy who are treated with medication do not need to be isolated from society.
    Source: Leprosy (Hansen's Disease) (rarediseases.about.com)

Epidemiology
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    Leprosy can affect people of all races all around the world. However, it is most common in warm, wet areas in the tropics and subtropics. Worldwide prevalence is reported to be around 5.5 million, with 80% of these cases found in 5 countries: India, Indonesia, Myanmar, Brazil and Nigeria.
    Leprosy presents most often during two different periods of life, between the ages of 10 and 14 and in those aged 35-44 years old. It is rarely seen in infants.
    Source: Leprosy (Hansen disease). DermNet NZ (dermnetnz.org)

Prevention
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    Prevention consists of avoiding close physical contact with untreated people. People on long-term medication become noninfectious (they do not transmit the organism that causes the disease).
    Source: Leprosy (healthscout.com)

Symptoms
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    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.
    (Details: open / close)
    Source: Leprosy (webmd.com)

Diagnosis
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  • Lepromin skin test can be used to distinguish lepromatous from tuberculoid leprosy, but is not used for diagnosis. The lepromin skin test is used to determine what type of leprosy a person has. It involves the injection of a standardized extract of inactivated leprosy-causing bacteria under the skin.
  • Skin scraping examination for acid fast bacteria where a piece of skin is removed to diagnose or rule out the disease.
    Source: MedlinePlus Medical Encyclopedia: Leprosy (nlm.nih.gov)

Treatment
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    Management of leprosy is aimed at stopping infection and minimising potential physical deformities. Antibiotics used first-line to eliminate organisms include dapsone, rifampicin and clofazimine. Varying regimens are used depending on the type of leprosy and the severity of infection. This may be a combination of two or three antibiotics given over varying lengths of time (up to years). Other antibiotics include minocycline, ofloxacin and clarithromycin.
    Oral corticosteroids and thalidomide are helpful in preventing nerve damage by reducing swelling. Long courses are necessary to decrease severity of deformities and disabilities.
    Surgery may sometimes be used to drain abscesses to restore nerve function, reconstruct collapsed nose, or to improve function or appearance of affected areas.
    Leprosy can be cured but it is essential to take the full course of medication. It is no longer infectious once treatment has begun.
    Source: Leprosy (Hansen disease). DermNet NZ (dermnetnz.org)

Illustrations
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Source: HONmedia - (www.hon.ch)


Lepromatous Leprosy

News
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Scientific Articles (a selection for patients)
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    Corticosteroids for treating nerve damage in leprosy
    (Details: open / close)
    Source: Corticosteroids for treating nerve damage in leprosy (cochrane.org)

Scientific Articles (a selection for health professionals)
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