Leprosy

Leprosy

1. Definition Leprosy, also known as Hansen's disease, is a chronic bacterial infection caused by Mycobacterium leprae that affects the skin, peripheral nerves, mucous membranes, and other parts of the body.

2. Causes / Etiology Leprosy is caused by the bacterium Mycobacterium leprae, which is transmitted from person to person through respiratory droplets. It is believed to be caused by a combination of genetic and environmental factors, with a higher risk of infection in people with weakened immune systems.

3. Types or Classification There are two main types of leprosy:

• Tuberculoid Leprosy: This is a mild form of leprosy where the body's immune system is able to fight off the infection, resulting in a few small skin lesions and nerve damage.

• Lepromatous Leprosy: This is a more severe form of leprosy where the body's immune system is unable to fight off the infection, resulting in widespread skin lesions and nerve damage.

• Borderline Tuberculoid Leprosy: This type of leprosy is a combination of the two main types, with some areas of the body showing a more severe reaction to the infection.

• Borderline Lepromatous Leprosy: This type of leprosy is also a combination of the two main types, with some areas of the body showing a more severe reaction to the infection.

• Lepromatous Leprosy with Erythema Nodosum Leprosum (ENL): This is a type of leprosy where the body's immune system reacts to the infection by forming painful nodules under the skin.

4. Pathology The pathology of leprosy involves the following steps:

Step 1 → The bacteria Mycobacterium leprae enters the body through the respiratory tract.

Step 2 → The bacteria travel to the nerve endings and skin cells, where they multiply and cause damage.

Step 3 → The body's immune system responds to the infection by forming granulomas, which are clusters of immune cells that try to fight off the bacteria.

Step 4 → The granulomas can cause damage to the skin and nerves, leading to the characteristic skin lesions and nerve damage seen in leprosy.

5. Clinical Features The clinical features of leprosy include:

• General features:

  • Skin lesions
  • Nerve damage
  • Muscle weakness
  • Loss of sensation

• Specific features:

  • Tuberculoid Leprosy:
    • Few small skin lesions
    • Nerve damage
  • Lepromatous Leprosy:
    • Widespread skin lesions
    • Nerve damage
    • Loss of sensation
    • Muscle weakness

6. Complications The complications of leprosy include:

• Acute complications:

  • Eye damage
  • Ear damage
  • Joint damage
  • Muscle weakness

• Chronic complications:

  • Disability
  • Disfigurement
  • Depression
  • Anxiety

7. Diagnosis / Investigations The diagnosis of leprosy involves:

• Routine tests:

  • Blood tests
  • Skin scrapings
  • Biopsy

• Special tests:

  • Skin patch test
  • Nerve conduction studies
  • MRI scans

8. Management The management of leprosy involves:

• General management:

  • Rest
  • Relaxation
  • Dietary changes

• Modern treatment:

  • Antibiotics (e.g. rifampicin, clofazimine)
  • Steroids

• Dietary advice:

  • Balanced diet
  • Adequate nutrition
  • Avoidance of spicy foods

9. Homeopathic Therapeutics The homeopathic remedies for leprosy include:

• Arsenic album: • Skin lesions • Nerve damage • Muscle weakness • Loss of sensation • Depression • Anxiety

• Graphites: • Skin lesions • Nerve damage • Joint damage • Muscle weakness • Loss of sensation • Depression

• Hydrastis: • Skin lesions • Nerve damage • Muscle weakness • Loss of sensation • Depression • Anxiety

• Lycopodium: • Skin lesions • Nerve damage • Joint damage • Muscle weakness • Loss of sensation • Depression

• Sulphur: • Skin lesions • Nerve damage • Joint damage • Muscle weakness • Loss of sensation • Depression