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Leprosy Lec

Leprosy, also known as Hansen's disease, is a chronic infectious disease caused by the bacteria Mycobacterium leprae. It primarily affects the nerves, skin, eyes, and mucous membranes. Gerhard Hansen discovered the bacteria that causes leprosy in 1873. Leprosy is transmitted through droplets from the nose and mouth of untreated patients and can also be transmitted through prolonged skin contact. While curable with multidrug therapy, leprosy continues to cause nerve damage and deformities if left untreated.

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98 views26 pages

Leprosy Lec

Leprosy, also known as Hansen's disease, is a chronic infectious disease caused by the bacteria Mycobacterium leprae. It primarily affects the nerves, skin, eyes, and mucous membranes. Gerhard Hansen discovered the bacteria that causes leprosy in 1873. Leprosy is transmitted through droplets from the nose and mouth of untreated patients and can also be transmitted through prolonged skin contact. While curable with multidrug therapy, leprosy continues to cause nerve damage and deformities if left untreated.

Uploaded by

AL Babaran Canceran
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Leprosy

(Hansen’s Disease)
(Lepi: scales on the fish)

1
Discovered by
Gerhard
Armauer
Hansen in
1873

2
Leprosy (Hansen’s disease) is a
chronic, systemic infectious disease,
affecting primarily the peripheral
nerves and secondarily the skin,
mucous membranes, the eyes,
bones, lymph nodes and viscera.

3
 Chronic granulomatous infection caused by Acid
Fast Bacteria Mycobacterium leprae (Ml)
 Ml cannot be grown on culture media--- in vitro
drug sensitivity is not possible
 Growth and Drug susceptibility are done by
injecting inoculate in mouse foot pad
 Live dormant in macrophages but alive
 Transmitted from person to person through nose,
skin lesions of the infected persons.
 Affect mainly PNS, NS, Skin and various tissues

4
5
Bacteria Resides in
Cooler Parts of the Body

Skin Peripheral Nerves


6
Mode of infection:
Leprosy is slow communicable disease and
uncubation period is between first exposure
and appearance of signs of disease.
Direct contact: Prolonged close contact of
susceptible individuals to an open case of
leprosy (damaged skin, nasal secretions,
mucous membrane contact).
Materno- foetal transmission.
Transmission from milk from mother to
infant.

7
Transmission

 Nasal/oral Droplets
 Dermal Inoculations

8
Armadillo

 They transmit
leprosy
 They act as animal
model along with
monkey, mice and
rabbit

9
Incidence

 At highest risk are those living in endemic


areas (hot and moist) with poor
conditions such as inadequate bedding,
contaminated water, and insufficient diet,
or other diseases that compromise
immune function.
 Acc to WHO- India, Brazil, Indonesia,
Myanmar and Nigeria are with the most
cases.

10
Classification
 Main 2 types:
 Tuberculoid type: high resistance.
 Lepromatous or low resistance
 Cass not falling in these 2 are considered
as borderline leprosy.

11
Classification
Based on the clinical, bacteriologic, immunologic and
histopathologic features, leprosy is classified into main
types:
1. Paucibacillary example: (Tuberculoid leprosy) (TL)
(with scanty or absent bacilli) - Skin lesions,
loss of sensation.
2. Multibacillary (Border line) (with numerous
bacilli)---numerous skin lesions, loss of sensation,
can go to
3. Multibacillary (lepromatous leprosy) (LL).
Nodules and plaques, thickened dermis, loss of
sensation, neuronal damage, nasal congestion,
epistaxis.
12
Symptoms
 Leprosy attacks the nervous system,
particularly the nerves of the hands, feet and
face.
 In tuberculoid leprosy, skin lesions typically
develop in areas of nerve damage. Skin
becomes pale, may develop a reddish copper
colour.
 Lepromatous leprosy: Loss of sensation to pin-
prick or light touch. Starts at the fingers and
toes, affect a small patch of skin to begin with,
but as time passes many skin lesions and
nodules develop. Organ deformaties 13
Tuberculoid Leprosy
The bacilli are usually absent in slit-skin
smears.
The histopathology shows tuberculoid
granulomas composed of epithelioid cells
surrounded by a zone of lymphocytes.
Lepromin test is strongly positive.

14
Tuberculoid Leprosy

15
Lepromatous Laprosy
Cutaneous lesions consist of
macules, papules, infiltration or
nodules (lepromas).
They are numerous, bilateral,
symmetrical, ill-defined with shiny
surface.
The sites commonly affected are
the face, arms, legs and buttocks,
but may be anywhere.

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Diagnosis
1-Clinical symptom diagnosis:
(anesthesia, nerve enlargement, and
characteristic skin lesions).
2-Slit-skin smears: Ziehl Neelson staining
of skin smear.
3-Skin biopsy.
4-Nerve biopsy.
5-Lepromin test.

18
1. Clinical symptom diagnosis

19
2. Skin Smear Tests
Ziehl Neelsen Carbol Fuchsin Stain (ZNCF)

Absence of bacteria in smear: Paucibacillary


Presence of bacteria in smear: Multibacillary
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3. Lepromin test
It is an immunologic test indicative of host resistance to
M. leprae.
A sample of inactivated (unable to cause infection)
leprosy-causing bacteria is injected just under the skin,
usually on the forearm

Tuberculoid: The immune system recognizes and


produces allergic reaction: Positive

Lepromatous: The immune system does not recognizes


Negative

21
Mechanism of Nerve Damage

Entry Through Blood Vessels


Inflammatory Response
Demyelination

22
Outcomes of Nerve Damage

 Sensory Loss

 Paralysis

 Deformities

23
Classification of Drugs

Sulfones: Dapsone (weak bactericidal)


MDT: Dapsone + Clofazimine + Rifampicin

Antibiotics: Ofloxacin, Clarithromycin,


Minocyclin

24
1995: WHO Distributes MDT Drugs for
Free to Worldwide Patients

World leprosy day January


30 in remembrance of

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