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Overview

Leprosy - Symptom, Treatment And Causes

What is leprosy?

Mycobacterium leprae is a bacterium which causes a progressive, chronic bacterial infection called leprosy. The nerves in the nose’s lining, the upper respiratory tract and in the extremities get affected by it. Leprosy produces nerve damage, muscle weakness and skin sores. If not treated, it may result in significant disability and severe disfigurement. Leprosy is quite common in lots of countries, especially those having subtropical or tropical climates. Leprosy has been classified in three different ways. The first kind recognizes two different leprosy types: lepromatous and tuberculoid. The immune response of a person towards the disease, dictates the kind of leprosy. Only few skin sores show and there is good immune response in people having tuberculoid leprosy. The disease isn’t severe and is not highly contagious. In those having lepromatous leprosy, immune response isn’t high and the nerves, skin and few other organs are affected. Nodules and wide spread lesions are found. It is highly contagious. Another way of classifying it is dependent on the number of skin areas affected and the type. Paucibacillary is the first type which has five or lesser lesions without any bacteria detection in the samples taken from the skin. Multibacillary is the second category which has higher than five lesions, bacteria gets detected in the skin’s smear or even both. An infected individual’s mucus can lead to the spread of leprosy. This usually happens when an infected individual coughs or sneezes. The disease is not highly contagious. Close contact repeatedly with someone who hasn’t been treated can cause transmission of leprosy. The bacteria causing leprosy multiply slowly over a long period of time. The disease can incubate for over five years. Symptoms might not show up till 20 years. The doctor can carry out a physical examination to search for symptoms and telltale signs of the disease. They also carry out scraping or skin biopsy. The doctor removes a small part of the skin and sends the sample to the lab for testing. They might even conduct lepromin test of the skin for determining the kind of leprosy. The doctor injects a tiny amount of leprosy inducing bacteria in the skin, usually in the upper part of the fore arm. People having borderline tuberculoid or tuberculoid leprosy have irritation at the site of injection. The World Health Organization has come up with a multiple drug therapy for curing all kinds of leprosy. It is available worldwide for free of cost. Quite a few antibiotics are also available for killing the leprosy causing bacteria. Your doctor might prescribe multiple antibiotics at once.

These antibiotics are:

Treatable by medical professional Require medical diagnosis Lab test required Chronic: can last for years or be lifelong Spread through the air or contaminated surfaces
Symptoms
Pain in the eyes or foot. Loss of colour, lumps, small bump, ulcers, or redness on the skin. Physical deformity. Reduced sensation and numbness.

Popular Health Tips

What is Leprosy - Types, Symptoms, Treatment and more!

MBBS
Internal Medicine Specialist, Delhi

Leprosy:

Leprosy is a chronic contagious disease induced by Mycobacterium leprae bacterium. The disease primarily affects the skin, the exterior nerves, the nasal lining, the upper respiratory tract and the eyes. Leprosy damages the nerves, weakens the muscles and leads to skin sores in the body. It can lead to severe deformities and disabilities if not treated on time. This disease can trigger in early infancy and may even develop in adulthood.

Leprosy is among the primogenital diseases in history. References to this disease have been found from 600 B.C (as per the source from World Health Organization (WHO)).

Leprosy is also known by the name of Hansen’s disease. Leprosy is prevalent in various countries, mostly which have tropical or subtropical temperatures.

Types of Leprosy:

There are three different systems of classification of leprosy. According to the first system, leprosy is of two types: tuberculoid and lepromatous. Here, the immune response of a person to the disease defines what type of leprosy he/she has.

For example, in tuberculoid leprosy, a person exhibits good immune response with only a few skin sores on the body. This type of leprosy is considered mild and less contagious.

However, in lepromatous leprosy, the immune response is low and it causes extensive lesions and nodules on skin and also affects the nerves and other vital organs of the body. This form of leprosy is severe and highly contagious.

WHO classifies leprosy based on the kind and number of affected skin regions. According to them, the first type of leprosy is paucibacillary. In this category, there are five or lesser sores without any bacteria found in the skin sample. In the second type of leprosy, which is called multibacillary, there are greater than five sores with bacteria found in the skin sample.

There is another system called Ridley-Jopling system used by Clinical studies to classify leprosy depending on the type of symptoms. According to this system, there are six types of leprosy:

- intermediate leprosy: is that form of the disease where only some lesions appear that may heal by themselves or turn into a more severe form.

- tuberculoid leprosy: is a category in which few flat sores, some big and numb, with few lesions involving nerves are found; this form of leprosy may heal by itself, continue, or increase to a greater degree of severity.

- borderline tuberculoid leprosy: in this from wounds are like tuberculoid though smaller in size and more in number; with less nerve involvement; this form may continue, change to tuberculoid, or progress to other forms of the disease.

- mid-borderline leprosy: symptoms of this form are swollen lymph glands, rosy lesions with some numbness, which may reduce, continue, or advance to severe forms.

- borderline lepromatous leprosy: numerous lesions, some of which are flat, raised wounds, plaques, and lumps, with numbness; symptoms may continue, retrogress, or progress.

- lepromatous leprosy: in this form, numerous lesions develop with the presence of bacteria; patient has hair loss, nerve impairment, limb numbness, disabilities, and the symptoms do not retreat.

Transmission of Leprosy:

The exact method of spread of leprosy is unknown. However, the common belief is that the disease is transmitted by human contact with an infected person.  Recent studies point out to the respiratory tract as a possible route of transmission. There could be possibilities of the spread of the disease through insects too.

Leprosy is a highly contagious disease that spreads through the mucus of an infected person, usually when he/she sneezes or coughs. The bacterium that transmits the disease multiplies at a very slow rate. The incubation period i.e. the time between transmission and the onset of the first symptoms is like five years. The infected person may have the symptoms for as long as 20 years.

Signs/Symptoms

The cardinal signs of leprosy include:

- weakness in body muscles

- numb feeling in the hands, arms, legs, and feet

- skin abrasions

- thickened nerves causing nerve injuries

- painless ulcers

- eye damage

- hair loss (eyebrows)

- other deformities or disabilities of body organs

The skin sores become less sensitive to touch, pain or temperature variations. They persist till many weeks and become lighter as compared to the normal skin tone.

Diagnosis

Clinical diagnosis is through signs and symptoms like Hypopigmented patches of skin or red patches of skin with sensory loss or nerve damage or both.

Mostly, a skin biopsy or scraping is performed by a specialist. A small part of skin is removed and sent it to a lab for testing.

A lepromin skin test may also be performed to define the type of leprosy. For this, the doctor injects a small dose of leprosy-causing bacterium into the skin, usually in the upper arms. Patients with tuberculoid or borderline tuberculoid leprosy experience irritation with this injection.

There are other tests like CBC (complete blood count), creatinine test, LFT (liver function test), or a nerve biopsy that are conducted to see whether other body organs have been impacted.

Treatment

Leprosy can be cured with a multidrug therapy (MDT). Multidrugs are used because treatment with just a single antileprosy drug also called monotherapy can lead to a person becoming resistant to that drug. Treatment of Leprosy can last for six months or up to a year. The kind of drugs combined to develop the MDT is largely dependent on the category or form the disease has taken. Rifampicin is the key antileprosy drug used in the treatment of both the kinds of leprosy. For patients with multibacillary leprosy, it is recommended to use a combination of rifampicin, clofazimine and dapsone (as per WHO rules); for those with paucibacillary leprosy, a mix of rifampicin and dapsone is used to make the MDT.

Doctors even prescribe more than one antibiotic at a time. They may also give you an anti-inflammatory medicine such as aspirin, prednisone, or orthalidomide. Thalidomide is not recommended in pregnancy cases as it can lead to various birth defects.

Multidrug therapy (MDT) was first brought to notice by WHO in 1984. Soon it became the standard remedy for treating leprosy and WHO started supplying it free of cost to all countries prone to the disease. 

Complications

Leprosy is a disease that grows very slowly and the symptoms may appear for 20 years. If detected in the early phase, there are minor complications. But if treatment is delayed or the disease is diagnosed late, the complications can become severe. Some of the major complications witnesses are:

- loss of sensation in extremities

- nervous impairment 

- weakened muscles

- continued disfigurement (such as loss of eyebrows, disfigurement of the toes, fingers, and nose)

Risk Factors

People living in endemic areas are at a higher risk of contracting the disease. The disease is widespread in various parts of India, Nepal, Japan, Egypt, China and other areas across the world.

Those people who are in regular contact with infected persons for a sustained period of time have greater chances of getting the infection.

Some studies even provided evidence of the fact that genetic defects like region q25 on chromosome 6 may lead some people to have more possibilities of contracting the disease. Moreover, certain animals are known to carry the bacteria (such as sooty mangabey, armadillos, African chimpanzee, and cynomolgus macaque). People in contact with these animals are also at risk of being transmitted with the bacteria causing leprosy.

Myths

Myth #1: Leprosy does not exist anymore

Every two minutes, a person is diagnosed with leprosy. There are millions with the disease that are left undiagnosed every year. About two million people across the world have been already disabled by leprosy. The social stigma linked to the disease keeps people away from getting the right treatment, thus leading to life-term deformities in their body organs. Therefore, it is very important to do away with this prejudice associated if we want to end leprosy forever.

Myth #2: Leprosy cannot be cured

Leprosy is 100% curable through a multi-drug treatment, which involves a combination of two or more drugs.  Once treatment is started in an infected person, chances of spread of the infection become very less or is completely ruled out.

Myth #3: Leprosy may lead to loss of fingers, toes, and limbs

Leprosy does not lead to loss of body organs. However, it can cause deformities or disabilities in the body organs due to nerve damage, especially in the areas like face, hands and feet. The nerve damage leads to sensory loss in these areas and sometimes, motor function or movement of limbs is compromised. A person may not be able to blink, move their hands and fingers or get hold of objects.  

Small lesions may lead to ulcers and infection. This causes shortening of digits not falling off or completes loss.  With severe forms of leprosy, walking and moving abilities may also be crippled. When facial nerves are affected, it might lead to eye damage or blindness.

Myth #4: Leprosy affects the elder population

Since leprosy has a long incubation period, symptoms appear very late in life causing people to think so. Whereas the fact is that leprosy has no relation to age and recent cases that have come to light consist of 10% children.

Myth #5: Leprosy is the consequence of sins of past life or immoral character

This is just a superstition. Leprosy is caused by bacterium Myobacterium leprae.

Myth #6: A person infected with leprosy should be isolated

Not really. A person undergoing treatment will not transmit the disease as the bacterium is killed with antibiotic drugs and the infection is no longer contagious. Thus, the infected person under treatment does not need to be isolated from the rest.

Important Facts of Leprosy:

- Leprosy is a contagious disease that develops slowly and damages the skin and the nerves.

- Leprosy is caused by bacterium Mycobacterium leprae.

- Early signs appear in skin extremities with loss of sensation.

- Symptoms of leprosy are painless ulcers, skin sores, muscle weakness, and eye damage.

- In later stages, ulcers grow large, fingers and toes are clawed, and facial disfigurement is seen.

- The infection is transmitted via human mucus or nasal droplets.

- Leprosy is rarely spread through animals like chimpanzees, armadillos, mangabey monkeys.

- Some genetic abnormalities may also lead to leprosy in a person.

- Antibiotics and Multi-drug Therapy are used to treat leprosy.

FAQS

1. Leprosy is an old disease, does it still exist?

Ans: Yes – about 200,000 plus new people are diagnosed with leprosy every year across the world. And there are 3 million people living with permanent disabilities due to leprosy.

2. Does leprosy cause claw hand and can it be treated?

Ans: Yes, leprosy may cause claw hands or toes. Since leprosy first damages the small nerves in the skin's extremities, it spreads to other areas with large nerves like in the knee, elbow, wrist, and ankle when anti-leprotic drugs are not given on time. This further leads sensory loss in the hands and feet. Muscles are paralyzed, causing clawed hands and toes.

It can be treated by reconstructive surgery that corrects the deformities in the hands and feet. Motor function can be restored through a muscle transfer technique. Physiotherapy also helps to strengthen the muscles.

3. Do fingers and toes disassociate from the body due to leprosy?

Ans: No. Due to nerve damage, there is sensory loss in a person’s areas like hands and feet. Many a times, people injure themselves due to loos of sensation in their body parts leading to loss or shrinkage of tissues. Bones of fingers and toes become shortened, thus making them appear lost or removed.

4. How does leprosy spread?

Ans: Leprosy is mainly spread through contact with the nasal mucus of an infected person, either while sneezing or coughing. A person with close and persistent contact with an infected person who is not being treated with MDT can acquire the disease. 

5. Is leprosy highly infectious?

Ans: Around 95% of the world population is naturally immune to the disease. The chances and rate of infection is very less due to the same fact.

6. What if a pregnant women catches leprosy?

Ans: It has been observed that women with leprosy deliver normal babies and the disease is not found to be transmitted from the mother to the baby. Pregnant mothers with leprosy are given MDT thereby nulling any chances of transferring the disease to their babies.

Leprosy Vaccination

Bachelor of Unani Medicine & Surgery (B.U.M.S)
Unani Specialist, Gaya
3 people found this helpful

Homeopathic Treatment For Leprosy!

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
Homeopathic Treatment For Leprosy!

Leprosy is also known as Hansen’s disease. It is a chronic dermatological disorder caused by the bacteria Mycobacterium Leprae. The peripheral nerves and mucosa of the upper respiratory tract are affected by the bacteria. Leprosy starts by the appearance of scaly skin lesions. If not treated in the primary stage, it can progress rapidly and cause permanent damage to the skin. It can damage the eyes, nerves and limbs. Leprosy can be moderately contagious, therefore it is necessary for the patient to be quarantined during the course of the treatment to prevent the spread of disease among other family members.

It has been noticed that after prolonged homeopathy treatment, almost 80% cases have been cured and improved. The patients have recovered senses in their limbs; the wounds have improved and in some cases, miraculously disappeared.

Homeopathy and Leprosy
There have also been cases where patients have responded better to homeopathic treatment than the multi-drug treatment regime that most doctors prescribe to leprosy patients. This could be because homeopathy is the safest and a non-toxic remedy to most diseases that does not complicate the health by causing adverse side effects.

A wonder medicine used for the treatment of leprosy is an anti-syphilitic medicine called Mercurius Solubilis. With an extremely high potency of 200, it is known to be an excellent remedy for leprosy. Homeopathic medicines are selected based on the symptoms. First the treatment is done on the symptoms so as to provide relief as soon as possible. Homeopathic medicines then act on the root cause of the disease, also providing bacterial resistance. It helps to retard the progress of the disease. Along with it, homeopathic medicines also help to reduce lepra reactions, and start reviving the damaged nerves, limbs and skin. It also strengthens the immunity system.

Some combinations of homeopathic and natural medicines used to treat leprosy are:
1. Thuja
2. Sulphur
3. Tuberculinum
4. Calotropis
5. Chaulmoogra oil
6. Elaeis
7. Hydrocotyle
8. Apis

1 person found this helpful

Homeopathy Treatment For Leprosy!

BHMS, M.D (HOM)
Homeopath, Visakhapatnam
Homeopathy Treatment For Leprosy!

Leprosy is also known as Hansen’s disease. It is a chronic dermatological disorder caused by the bacteria Mycobacterium Leprae. The peripheral nerves and mucosa of the upper respiratory tract are affected by the bacteria. Leprosy starts by the appearance of scaly skin lesions. If not treated in the primary stage, it can progress rapidly and cause permanent damage to the skin. It can damage the eyes, nerves and limbs. Leprosy can be moderately contagious, therefore it is necessary for the patient to be quarantined during the course of the treatment to prevent the spread of disease among other family members.

It has been noticed that after prolonged homeopathy treatment, almost 80% cases have been cured and improved. The patients have recovered senses in their limbs; the wounds have improved and in some cases, miraculously disappeared.

Homeopathy and Leprosy
There have also been cases where patients have responded better to homeopathic treatment than the multi-drug treatment regime that most doctors prescribe to leprosy patients. This could be because homeopathy is the safest and a non-toxic remedy to most diseases that does not complicate the health by causing adverse side effects.

A wonder medicine used for the treatment of leprosy is an anti-syphilitic medicine called Mercurius Solubilis. With an extremely high potency of 200, it is known to be an excellent remedy for leprosy. Homeopathic medicines are selected based on the symptoms. First the treatment is done on the symptoms so as to provide relief as soon as possible. Homeopathic medicines then act on the root cause of the disease, also providing bacterial resistance. It helps to retard the progress of the disease. Along with it, homeopathic medicines also help to reduce lepra reactions, and start reviving the damaged nerves, limbs and skin. It also strengthens the immunity system.

Some combinations of homeopathic and natural medicines used to treat leprosy are:
1. Thuja
2. Sulphur
3. Tuberculinum
4. Calotropis
5. Chaulmoogra oil
6. Elaeis
7. Hydrocotyle
8. Apis

In case you have a concern or query you can always consult an expert & get answers to your questions!

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Popular Questions & Answers

There are lot's of brown spots on my face and they are increasing day by day. I need some suggestion please. Right now I am taking MB MDT leprosy pure neurotic hansen treatment for enlarged nerve of right hand. Please suggest me treatment for brown spots on my face.

MD - Dermatology , Venereology & Leprosy, Diploma In Dermatology And Venerology And Leprosy (DDVL), MBBS
Dermatologist, Bangalore
If you are taking Hansepran(Clofozimine) that may cause pigmentation.You apply Moiz Lmf 48 lotion once daily. you can consult privately with photos.

Is the leprosy are a viral disease? What ate the common symptoms of it & what precautions it must be taken to avoid that?

Dermatology Backed Expert Skin & Hair Care Solution
Dermatologist, Kolkata
Dear Lybrate user Leprosy is caused by Mycobacterium leprae.. It can present with light coloured patches with loss of sensation or red raised lesions over body.. Treatment for 12 months is needed to cure the disease..
1 person found this helpful

I want to know what is the best diet nutrition for leprosy patient and what is the side effect of dapsone and hansepran tablet.

MBBS
General Physician, Jalgaon
Please Take plenty of water Take salads and fruits more Take high protein diet, avoiding non beg Avoid fish, rice, brinjals There are less side effects of dapsone and hensepran.
4 people found this helpful

Table of Content

What is leprosy?

These antibiotics are:

Having issues? Consult a doctor for medical advice