Introduction

Leprosy is a granulomatous disease primarily affecting the peripheral nerves and skin. It is caused by Mycobacterium leprae.

Epidemiology

  • Incidence: 0.02 cases per 100,000 person-years
  • Peak incidence: 6-15 years
  • Sex ratio: 1:1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Pathophysiology

The degree of cell mediated immunity determines the type of leprosy a patient will develop.

Low degree of cell mediated immunity → lepromatous leprosy ('multibacillary')
  • extensive skin involvement
  • symmetrical nerve involvement

High degree of cell mediated immunity → tuberculoid leprosy ('paucibacillary')
  • limited skin disease
  • asymmetric nerve involvement

Clinical features

Features
  • patches of hypopigmented skin typically affecting the buttocks, face, and extensor surfaces of limbs
  • sensory loss

Management

Management
  • WHO-recommended triple therapy: rifampicin, dapsone and clofazimine
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