Simple notes of leprosy

defintion...:
it is a chronic granulomatous disease which affects pricipally the skin and peripheral nervous system , caused by acid fast stained bacilli called mycobactreium leprae or hansen's bacilli.

Types...:
1]low immunity patients develop lepromatous leprosy(LL)
2]moderate immunity patients develpe tuberculoid leprosy(TL)
3] mixed or border line leprosy.




Clinical manifestation...:
a]tuberculoid leprosy
*show hypopigmented macules which charactrized by loss of hair , loss of sensation and diminshed sweating.
*hypopigmented macules in white skin patient is present as erythamatous or brown discolouration .
B] lepramatous leprosy
it is serious lesion affecting many organs [liver, eye , spleen , glands.
When affect the nose wil cause epistaxis.
The lesion varies from papules , paques and subcutanous nodules .
Sensory nerve sensation are lost 1st then motor nerves are lost resulting in :[claw hand, drop foot ,resorptin of digits, and deformity of extremitis].





Diffrential diagnosis...:
1- vitiligo
2- post inflammatory hypopigmentaion
3- localized scleroderma[morphea]


Treatment...:

1-dapsone:* dialy 100mg
*used also in dermatitis herpatiformis
*contraindicated in cardiac disease ,pulmonary disease or anemia
*side effects: hemolysis- methmoglubenimia- allergic dapsone syndrome
2-rifampicin 600mg per month
3-clofazamine 300mg per month
-tuberculoid leprosy requires 6 months up to 2 years treatment.
-lepramatous leprosy requires about 3 to 5 years treatment.