Leprosy is a chronic infection involving nerves and the skin. It is caused by a bacteria called Mycobacterium leprae.
Leprosy occurs when thebacteria attacks tissues in the person's body. There are three forms of leprosy: lepromatous, the most serious type, which damages the upper respiratory tract, eyes, testes, nerves, and skintuberculoid, which affects peripheral nerves and, sometimes, the surrounding skin, especially on the face, arms, legs, and buttocksborderline, which has characteristics of both lepromatous and tuberculoid leprosy
The symptoms of leprosy include the following: one or more skin lesions that have decreased sensation to touch, heat, or painskin lesions that do not heal after several weeks or months numbness in the hands, arms, feet, or legsmuscle weaknessdisappearance of body hair, including eyebrows and eyelashes
Leprosy is caused by the bacteria. It is spread through contact with nasal secretions from an untreated, infected person. Close contact over a period of time is needed to transmit leprosy. It is not highly contagious, but it can also be transmitted through skin breaks, such as one made with a contaminated needle.
Children are more susceptible than adults to contracting leprosy. Nine out of 10 people may have a natural immunity to the disease. Leprosy is most prevalent in underdeveloped regions, especially China and India. Worldwide, approximately 11 million people have the disease.
Prevention involves avoiding close physical contact with a person who has untreated leprosy.
The diagnosis of leprosy begins with a medical history and physical examination. The characteristic skin lesions and loss of sensation allow the healthcare professional to diagnose the infection. Biopsies of skin lesions and peripheral nerves, and smears of skin or ulcerated mucous membranes, can help to confirm the diagnosis. Blood tests may be performed.
Leprosy damages nerves and causes a loss of sensation in the skin. The person can have repeated injuries without realizing it, since there is no perception of pain. The injuries can eventually result in ulcers, broken bones, and deformities. Nerve damage and physical disabilities can be permanent.
Leprosy is contagious and can be spread to others through contact with nasal secretions from an untreated, infected person.
Antibiotics are used to treat leprosy. The World Health Organization, or WHO, has developed treatment guidelines that include a combination of antibiotics, including the following: rifampin (i.e., Rifadin, Rimactane)dapsone clofazlimine (i.e., Lamprene)ethionamide (i.e., Trecator)minocycline (i.e., Minocin, Solodyn)clarithromycin (i.e., Biaxin)ofloxacin (i.e., Floxin)
In 1998, the Food and Drug Administration, or FDA, approved thalidomide (i.e., Thalomid) for the treatment of certain forms of leprosy. Since this medication can cause birth defects, there are strict guidelines for its use in women of childbearing age. Deformities such as wristdrop, footdrop, or clawhand may require surgery for correction.
Antibiotics may cause stomach upset, diarrhea, and allergic reaction. Surgery may cause bleeding, infection, or allergic reaction to anesthesia.
Antibiotic therapy must be continued for a long time because the bacteria that cause leprosy are difficult to destroy. Treatment may last from six months to many years. For those with deformities, a rehabilitation program involving physical therapy or occupational therapy can help maximize function.
A person with leprosy should be followed by his or her healthcare professional closely after treatment, since relapse does occur. Any new or worsening symptoms should be reported to the healthcare professional.
The Merck Manual of Medical Information, 1997
Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998