What are the other Names for this Condition? (Also known as/Synonyms)

• Hansen’s Disease
• Infection due to Mycobacterium Leprae
• Mycobacterium Leprae Infection

What is Leprosy? (Definition/Background Information)

• Leprosy is a chronic infectious disease caused by a bacillus (rod-shaped) bacterium called Mycobacterium leprae (M. leprae). Children are generally affected by this disease more than adults
• Leprosy affects the peripheral nerves, skin, upper respiratory tract, eyes, nose, and nasal mucosa, resulting in skin lesions, deformities, and disfigurement. In this condition, the cooler parts of the body, particularly the eyes, nose, earlobes, hands, feet, and testicles are affected
• Complications associated with Leprosy include disfigurement of body parts (complete erosion of the nose and, loss of fingers and toes due to loss of sensations and repeated trauma) and even blindness
• Antibiotics are used in the treatment of Leprosy. Early diagnosis and treatment is crucial for a better prognosis of the disease. Proper treatment and follow-up will enable the affected individual to lead a normal life
• The only way to prevent Leprosy is to avoid close physical contact with untreated, affected individuals

There are two types of Leprosy namely:

• Tuberculoid Leprosy or Paucibacillary Leprosy: It is a mild form of Leprosy that presents red patches of skin on the trunk or extremities, accompanied by a decrease in ‘light-touch’ sensation in such patches
•  Lepromatous Leprosy or Multibacillary leprosy: This is a more severe form of Leprosy with skin rashes that appear on the elbows, knees, buttocks, face, ears, and wrists

Who gets Leprosy? (Age and Sex Distribution)

Leprosy is a dangerous infection that may affect any individual, though children are more likely to be affected than adults.

Leprosy is prevalent in the following regions and nations:

• Indian subcontinent
• Brazil
• Certain parts of Africa such as Tanzania and Mozambique
• Madagascar

What are the Risk Factors for Leprosy? (Predisposing Factors)

Every individual is equally at risk for contracting Leprosy; although, the following individuals are at the highest risk:

• Children
• People living in countries with temperate, tropical, and subtropical climate
• Household contact with Leprosy-affected individuals
• Individuals who are immunocompromised
• Those living in overcrowded conditions
• Healthcare personnel who administer to the Leprosy-affected

Note: Contrary to belief, HIV infection does not seem to increase the risk for Leprosy.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Leprosy? (Etiology)

• Leprosy is caused by the bacteria Mycobacterium leprae, which belongs to the family of mycobacteriaceae. It is a contagious condition that spreads through infected respiratory droplets
• Leprosy mainly affects the skin, nerves, mucous membranes, upper respiratory passages, front portion of the eyes, hands, testes, feet, and leads to skin lesions, deformity, disfigurement, and lack of sensations

What are the Signs and Symptoms of Leprosy?

Leprosy is characterized by the following signs and symptoms:

Symptoms of Tuberculoid Leprosy:

• One or two red patches start appearing on the trunk or extremities along with a decrease in ‘light-touch’ sensation on such patches
• Skin stiffness and dryness
• Loss of fingers and toes
• Skin lesions with definite sensory loss, with or without thickened nerves
• Eye defects that may result in blindness
• Severe pain
• Muscle weakness in the hands and feet

Symptoms of Lepromatous Leprosy:

• Rashes start appearing on the elbows, knees, buttocks, face, ears, and wrists
• Thinning of eyebrows and eyelashes
• Thickened skin on the face
• Nasal stuffiness
• Nose bleeding, collapsing of the nose
• Swelling of the lymph nodes in the groin and armpits

How is Leprosy Diagnosed?

The diagnosis of Leprosy may include:

• Complete evaluation of medical history along with a thorough physical exam. In most cases, only a physical exam is sufficient for the diagnosis
• To confirm the diagnosis, a biopsy of the lesional tissue can be done, in which a small piece of tissue is taken and sent to a laboratory for examination under the microscope by a pathologist

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Leprosy?

Complications of Leprosy include:

• Disfigurement
• Blindness
• Complete erosion of the nose
• Loss of fingers and toes due to loss of sensation: Generally, the patients are unaware of the trauma to their hands and feet; repeated trauma results in the loss of fingers and toes
• Erectile dysfunction and infertility
• Kidney failure in severe cases

How is Leprosy Treated?

Antibiotics are the mainstay of treatment for Leprosy, which can help bring about a complete cure. Usually, combinations of antibiotics are given to destroy the bacteria that cause Leprosy, though this combination depends on whether Leprosy is paucibacillary type or multibacillary type. This is known as multi-drug therapy or MDT. The treatment may range from a period of 6 months to 2 years.

The antibiotics may include the following:

• Dapsone
• Rifampin
• Clofazamine
• Fluroquinolones
• Macrolides
• Minocycline

Surgery:

• Disfigurement of the face and body extremities may be surgically reconstructed (to the extent possible)
• Cosmetic surgery can help correct some of the facial defects
• Nerve surgery can also help bring about better motor function and improved sensation in the affected parts or limbs
• Physiotherapy may be provided to regain muscle control, control of the affected fingers/toes
• In extreme cases, some affected parts (finger or toes or limbs) may have to be amputated

How can Leprosy be Prevented?

• Leprosy is a contagious condition. It may be prevented by avoiding close physical contact with untreated individuals
• Vaccines are not commercially available to provide protection against this infection

What is the Prognosis of Leprosy? (Outcomes/Resolutions)

• Early diagnosis and treatment is crucial for an optimum outcome
• Proper treatment and follow-up of Leprosy will enable individuals to lead a better quality of life

Additional and Relevant Useful Information for Leprosy:

• Leprosy has a big social stigma attached with it. Ever since ancient (biblical) times, individuals with Leprosy have been excluded and cast-out (socially expelled) of villages and towns
• Leprosy is seen in some parts of California, Hawaii, and the US islands