Written by Navya Narang
Leprosy, also known as Hansen's disease, is a chronic infectious disease that primarily affects the skin and peripheral nerves. Despite being a neglected tropical disease, leprosy remains a significant health concern, with thousands of new cases reported each year worldwide. Leprosy is a chronic infectious condition caused by the bacterium Mycobacterium leprae. It has an impact on peripheral nerves. The bacteria have an affinity for nerve tissue, leading to nerve damage and loss of sensation in affected areas. This can result in injuries and infections going unnoticed, leading to further complications. Prolonged nerve injury can cause muscular weakness and atrophy, resulting in abnormalities in the hands, feet, and face. Clawed fingers and toes, as well as facial abnormalities, are common signs of severe leprosy.
The diagnosis of Leprosy usually happens in steps:
The first step in diagnosing leprosy is a comprehensive clinical examination performed by a healthcare expert. Skin lesions, nerve involvement, and other physical symptoms are thoroughly investigated.
Microscopic examination of skin smears is a crucial diagnostic tool for leprosy. A small sample of skin tissue is collected from the affected area and stained to identify the presence of Mycobacterium leprae, the bacteria responsible for leprosy. This method helps classify the disease into paucibacillary (few bacteria) or multibacillary (numerous bacteria) forms.
A skin biopsy may be performed in certain circumstances to confirm the diagnosis and measure the extent of tissue damage. Under a microscope, the biopsy sample is inspected to look for traits more-or-less specific to leprosy, such as granulomas and acid-fast bacilli.
Mycobacterium leprae genetic material can be found in skin samples using molecular methods like polymerase chain reaction (PCR). The leprosy diagnosis's sensitivity and specificity are improved by these techniques.
Once the diagnosis is confirmed, the treatment depends on the stage it was diagnosed at. Leprosy can be classified into different stages based on the extent of the disease and the number of bacteria present. The two main classifications are paucibacillary (PB) and multibacillary (MB) leprosy.
Paucibacillary (PB) Leprosy:
This form of leprosy is characterised by a low number of bacteria in the body.
The standard treatment for paucibacillary leprosy involves a combination of antibiotics, primarily Rifampicin and Dapsone. This is usually given for six months.
Multibacillary (MB) Leprosy:
MB leprosy is characterised by a higher bacterial load in the body, affecting more widespread areas.
The standard treatment for multibacillary leprosy involves a combination of stronger antibiotics, including Clofazimine along with Rifampicin and Dapsone. This is typically given for 12 months.
Along with this, regular follow-up examinations are important for both classifications of the treatment. Supportive care, including wound care and physical therapy, helps manage complications such as deformities and disabilities caused by nerve damage.
Moreover, close contacts of affected individuals are identified and monitored for symptoms as leprosy is contagious.
In conclusion, leprosy is a serious medical condition that affects millions of people worldwide and can have serious consequences if left untreated. In 2022 itself 174,087 new cases were registered. However, leprosy is curable with the right care and prompt action.
Works Cited
CDC. “Diagnosis and Treatment.” CDC, 2019, www.cdc.gov/leprosy/treatment/index.html. Accessed 20 Jan. 2024.
National Hansen's Disease (Leprosy) Program . “National Hansen’s Disease (Leprosy) Program Caring and Curing since 1894.” Official Web Site of the U.S. Health Resources & Services Administration, 13 Apr. 2017, www.hrsa.gov/hansens-disease. Accessed 21 Jan. 2024.
Statistica. “Leprosy New Cases Numbers Worldwide by Country 2020.” Statista, 2024, www.statista.com/statistics/871627/leprosy-new-cases-number-worldwide-by-country/.
World Health Organization . “Leprosy.” Www.who.int, 27 Jan. 2023, www.who.int/news-room/fact-sheets/detail/leprosy#:~:text=Leprosy%20is%20a%20neglected%20tropical. Accessed 20 Jan. 2024.
---. “Leprosy (Hansen’s Disease).” Who.int, 2022, www.who.int/data/gho/data/themes/topics/topic-details/GHO/leprosy#:~:text=In%202022%2C%20182%20countries%2C%20areas.
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