Leprosy, also known as Hansen's disease, is a chronic bacterial infection caused by Mycobacterium Mycobacterium Mycobacterium is a genus of the family Mycobacteriaceae in the phylum Actinobacteria. Mycobacteria comprise more than 150 species of facultative intracellular bacilli that are mostly obligate aerobes. Mycobacteria are responsible for multiple human infections including serious diseases, such as tuberculosis (M. tuberculosis), leprosy (M. leprae), and M. avium complex infections. Mycobacterium leprae complex bacteria Bacteria Bacteria are prokaryotic single-celled microorganisms that are metabolically active and divide by binary fission. Some of these organisms play a significant role in the pathogenesis of diseases. Bacteriology. Symptoms primarily affect Affect The feeling-tone accompaniment of an idea or mental representation. It is the most direct psychic derivative of instinct and the psychic representative of the various bodily changes by means of which instincts manifest themselves. Psychiatric Assessment the skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions and peripheral nerves Peripheral Nerves The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. Nervous System: Histology, resulting in cutaneous manifestations (e.g., hypopigmented macules) and neurologic manifestations (e.g., loss of sensation). Leprosy is known for its historical stigma and psychosocial effects on infected persons, prompting the World Health Organization (WHO) to pursue a disease elimination Elimination The initial damage and destruction of tumor cells by innate and adaptive immunity. Completion of the phase means no cancer growth. Cancer Immunotherapy plan that led to significant reduction in the prevalence Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. Measures of Disease Frequency of leprosy. The diagnosis of leprosy is established clinically and supported with skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions biopsy Biopsy Removal and pathologic examination of specimens from the living body. Ewing Sarcoma. It is treated with long-term multidrug antibiotic combinations. Untreated leprosy leads to disability Disability Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for social security and workman's compensation benefits. ABCDE Assessment and permanent damage to the skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions, nerves, limbs, and eyes.
Last updated: 17 Mar, 2021
Leprosy (also known as Hansen’s disease) is an infectious Infectious Febrile Infant disease affecting skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions and peripheral nerves Peripheral Nerves The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. Nervous System: Histology.
Leprosy is caused by Mycobacterium Mycobacterium Mycobacterium is a genus of the family Mycobacteriaceae in the phylum Actinobacteria. Mycobacteria comprise more than 150 species of facultative intracellular bacilli that are mostly obligate aerobes. Mycobacteria are responsible for multiple human infections including serious diseases, such as tuberculosis (M. tuberculosis), leprosy (M. leprae), and M. avium complex infections. Mycobacterium leprae complex bacteria Bacteria Bacteria are prokaryotic single-celled microorganisms that are metabolically active and divide by binary fission. Some of these organisms play a significant role in the pathogenesis of diseases. Bacteriology:
Risk factors for acquisition:
A nine-banded armadillo in the Green Swamp in central Florida
Image: “Armadillo” by http://www.birdphotos.com. License: CC BY 3.0Map of the range of the nine-banded armadillo in the United States
Image: “Map of the range of the Nine-banded Armadillo in the United States” by Caliga10. License: Public DomainSkin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions lesions:
Other manifestations:
Tuberculoid | Lepromatous | |
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Presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor | Immunocompetent individuals | Immunocompromised immunocompromised A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. Gastroenteritis individuals |
Location | Skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions and nerves | Skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions and nerves |
Symptoms |
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Late findings may include:
Possible immunologic reactions:
Lucio’s phenomenon:
Lagophthalmos in a patient with
lepromatous leprosy
Lepromatous Leprosy
Antimycobacterial Drugs:
Patient is attempting to close his
eyelids
Eyelids
Each of the upper and lower folds of skin which cover the eye when closed.
Blepharitis, but he is unable to do so.
Clawed fingers: Typical deformity Deformity Examination of the Upper Limbs in a patient with advanced leprosy
Image: “Typical Deformity Deformity Examination of the Upper Limbs in a Patient with Leprosy” by Andrea Rinaldi. License: CC BY 4.0Cutaneous manifestations of leprosy:
Photographs
Photographs
Ultrasound (Sonography) show reddish
patches
Patches
Vitiligo and plaques on the patient’s face (A), elbow (B), knee (C), and buttock (D)
Leprosy: erythematous skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions patches Patches Vitiligo
Image: “Erythematous rash Rash Rocky Mountain Spotted Fever in trunk” by Infectious Infectious Febrile Infant Diseases, Hattiesburg Clinic, Hattiesburg, Mississippi; Dermatology, Hattiesburg Clinic, Hattiesburg, Mississippi. License: CC BY 4.0Widespread
skin
Skin
The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue.
Skin: Structure and Functions lesions consistent with
lepromatous leprosy
Lepromatous Leprosy
Antimycobacterial Drugs:
The patient is beginning to develop leonine facies, with a large number of papules and nodules afflicting the face, chest, back, legs, and
groin
Groin
The external junctural region between the lower part of the abdomen and the thigh.
Male Genitourinary Examination. Large well-circumscribed plaques appear on the triceps aspect of the right
arm
Arm
The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior).
Arm: Anatomy and over his left shoulder and
right flank
Right Flank
Surgical Anatomy of the Abdomen.
The WHO defines leprosy as appearing in an individual who has not completed a course of treatment and has one or more of the following:
The WHO bases Bases Usually a hydroxide of lithium, sodium, potassium, rubidium or cesium, but also the carbonates of these metals, ammonia, and the amines. Acid-Base Balance diagnosis on the above clinical presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor combined with a confirmatory laboratory test.
Fite stain for M. leprae
Image: “Fite stain-positive for Mycobacterium Mycobacterium Mycobacterium is a genus of the family Mycobacteriaceae in the phylum Actinobacteria. Mycobacteria comprise more than 150 species of facultative intracellular bacilli that are mostly obligate aerobes. Mycobacteria are responsible for multiple human infections including serious diseases, such as tuberculosis (M. tuberculosis), leprosy (M. leprae), and M. avium complex infections. Mycobacterium spp” by Infectious Infectious Febrile Infant Diseases, Hattiesburg Clinic, Hattiesburg, Mississippi; Dermatology, Hattiesburg Clinic, Hattiesburg, Mississippi. License: CC BY 4.0Leprosy diagnosis:
A: Plasmacytic and lymphocytic infiltration surrounding dermal nerve and Schwann cells and inflammatory cells infiltrated into nerve tract
B: Positive acid-fast
bacilli
Bacilli
Shigella stain for M. leprae
bacilli
Bacilli
Shigella
Three
patients
Patients
Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.
Clinician–Patient Relationship suffering from leprosy:
Note the
nose
Nose
The nose is the human body’s primary organ of smell and functions as part of the upper respiratory system. The nose may be best known for inhaling oxygen and exhaling carbon dioxide, but it also contributes to other important functions, such as tasting. The anatomy of the nose can be divided into the external nose and the nasal cavity.
Nose and Nasal Cavity: Anatomy disfigurement and digit amputations.