What is Leprosy?

Leprosy, also known as Hansen’s disease, is a chronic infectious disease caused by the bacterium Mycobacterium leprae. It primarily affects the skin, peripheral nerves, upper respiratory tract, eyes, and testicles. While once feared and stigmatized, it is curable with multidrug therapy.
Table of Contents
Transmission
It is spread through prolonged close contact with an untreated person who has a multibacillary form of the disease. The bacteria are primarily transmitted through nasal secretions, particularly during sneezing or coughing.
Pathogenesis
Mycobacterium leprae is an obligate intracellular bacterium, meaning it can only survive and multiply inside host cells. It preferentially targets macrophages, a type of immune cell.
The bacteria have a slow growth rate, with a generation time of about 14 days. This explains the long incubation period, which can range from months to years.
Clinical Feature
It manifests in various ways, depending on the patient’s immune response and the extent of bacterial infection. It is broadly classified into two categories:
Tuberculoid Leprosy (TT)
Characterized by a strong immune response, limiting the spread of the bacteria.
Results in well-defined, hypopigmented skin lesions with raised, firm edges (plaques).
Typically affects a small area and is associated with nerve involvement, leading to numbness and weakness in the affected area.
Lepromatous Leprosy (LL)
Characterized by a weak immune response, allowing the bacteria to spread widely.
Results in numerous, diffuse skin lesions with a characteristic ‘lepromatous’ appearance: nodular, infiltrative, and often disfiguring.
Commonly affects the face, nose, and ears, leading to facial disfigurement.
Associated with systemic involvement, affecting organs like the eyes, testes, and upper respiratory tract.
Other Types
Borderline Leprosy
Represents a spectrum between TT and LL, with varying degrees of immune response and clinical manifestations.
Indeterminate Leprosy
Often presents as a single, hypopigmented skin lesion with minimal nerve involvement.
Complications
Nerve Damage: The most serious complication, leading to sensory loss, weakness, paralysis, and deformities.

Eye Damage: Can lead to blindness due to keratitis, iritis, and optic nerve involvement.

Lepromatous Reactions: Episodes of inflammation and tissue damage, often triggered by treatment.
Social Stigma: Still persists in many parts of the world, leading to isolation and discrimination.
Diagnosis
Diagnosis relies on a combination of clinical examination, skin biopsies, and laboratory tests:
Clinical Examination: Assessing skin lesions, nerve involvement, and other signs.
Skin Biopsy: Examining skin tissue for Mycobacterium leprae under a microscope.
Laboratory Tests: Including polymerase chain reaction (PCR) for detecting bacterial DNA, and slit skin smear for identifying bacteria in skin samples.
Treatment
Multidrug therapy (MDT) is the cornerstone of its treatment. It involves a combination of antibiotics for a prolonged period, typically 6-12 months.
MDT drugs include
Rifampicin: A bactericidal drug, effective against actively multiplying bacteria.
Dapsone: A bacteriostatic drug, preventing bacterial growth.
Clofazimine: A bactericidal drug with anti-inflammatory properties.
Prevention
Early Diagnosis and Treatment: Promptly treating affected individuals prevents further transmission.
Contact Tracing: Identifying and treating close contacts of infected individuals.
Public Health Education: Raising awareness about it, its transmission, and prevention strategies.
Conclusion
Leprosy is a curable chronic infectious disease that requires prompt diagnosis and treatment to prevent complications. With effective multidrug therapy and public health measures, leprosy can be controlled and eliminated. However, social stigma and discrimination against those with leprosy remain a major challenge.
Frequently Asked Questions(FAQ)
Write about Theraphy?
Therapy is simply a safe place to explore and grow; the term is often misunderstood or stigmatized. It is a chance to unravel the complexities of your thoughts, emotions, and behaviors; it is a journey into the depths of your mind.
What is iritis?
Iritis is the inflammation of the iris, or the colored part of your eye. The area between the iris and the cornea, or the anterior chamber, of the eye is also affected. Iritis can cause serious issues. It has the potential to cause blindness and significant vision loss.
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