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Leprosy, also known as Hansen’s disease, is a bacterial infection caused by Mycobacterium leprae (M. leprae) and Mycobacterium lepromatosis (M. lepromatosis). It affects the skin and peripheral nerves. A study by the World Health Organisation (WHO) has found that the rate of prevalence of leprosy throughout the world is 16.7 per 1 million people .
These bacteria attack the skin and nervous system. Gradually, complications may develop, causing paralysis or complete loss of efficiency in hands, legs, feet, eyes, etc. In India, the rate of noticeable deformities is 1.1 in every 10,000 population .
Individuals must get the treatment before it spreads further and causes harm or damage to nerves. For this, early diagnosis and initiation of treatment are imperative.
|Symptoms||Skin lesions, ulcers, swelling, thick skin, paralysis, increased nerves, numbness, ocular problems, nosebleeds|
|Complications||Abscesses on nerve, cranial nerve palsy, lagophthalmos, corneal insensitivity, naturopathy, distal insensitivity|
|Causes||Infections caused due to Mycobacterium leprae and Mycobacterium lepromatosis|
|Onset||A few months to 20 years|
|Diagnosis||Skin biopsy, polymerase chain reaction (PCR), serological test|
|Medication||Clofazimine, thalidomide, corticosteroids, macrolides, minocycline, fluroquinolones, clofazimine, rifampin, dapsone|
Here’s a detailed overview of leprosy – its symptoms, types, diagnosis, treatment, and complications. Read on to learn more.
Hansen’s disease or leprosy may affect or damage the nerves, which causes the loss of sensation. You may not be able to feel the pain or effect of injury or burns caused due to leprosy. So, it may become difficult to notice whether you have developed this condition .
You can witness symptoms of leprosy on nerves, skin and mucous membranes, as mentioned below:
Following are some signs you can witness on your skin if you suffer from leprosy:
You can develop the following issues as symptoms of leprosy:
Here are some symptoms you can develop on the mucous membrane:
The infectious disorder leprosy is caused by the acid-fast bacilli M. leprae and M. lepromatosis. You may develop the disease after exposure to these bacteria. Nevertheless, genetic variation and its effect on an individual’s immune system significantly influence the vulnerability to leprosy .
The human body makes its non-specific initial reaction against invading bacteria upon the first exposure. It acts as the first line of defence of the human body. Nevertheless, if it fails, the immune system also makes the necessary response targeting the infection caused due to the pathogen. It restricts the growth of infection and takes it under control.
If the immune response developed within the body upon exposure to M. leprae and M. lepromatosis is inadequate, the bacteria spreads at a rapid rate. Gradually, it advances through the skin and reaches peripheral nerves and other deeper tissues. In such circumstances, you will develop severe symptoms of leprosy.
The medical condition of leprosy is categorised differently according to different systems, as mentioned below :
Following are different classifications of leprosy according to the Ridley-Jopling system:
This Ridley-Jopling classification considers the intensity of immune response as the base of differentiation.
Besides this, WHO also classifies leprosy according to the quantity of available lesions on the skin. These are as follows:
Multibacillary (MB) Leprosy: Patients with MB leprosy develop more than five lesions. The skin smear test of these lesions gives a positive result.
It is imperative that you get the necessary medical attention after the diagnosis of leprosy without much delay. This will help you ensure that the infections or impairments caused due to leprosy do not spread much. You can reduce the chances of developing complications like damage to nerves which are not curable.
It becomes quite easy for healthcare experts to manage your leprosy complications when you reach out at an early stage. Under such circumstances, you may only have to take multi-drug therapy to get your complications under control or to recover from leprosy and can avoid surgical treatment procedures.
Histopathological assessment is the method for diagnosing leprosy in the laboratory. In this process, the serologist mainly uses Polymerase Chain Reaction (PCR) and skin biopsies to establish whether an individual has developed leprosy.
Following are the different diagnostic tests for leprosy:
The serologist conducts a complete biopsy of the affected tissues, considering the severity of the observable lesions. Through the biopsy, they can even classify the type of leprosy. The serologist performs eosin and haematoxylin sectioning to detect the variation in the leprosy spectrum.
Serologists generally take a large and deep specimen of the subcutaneous fat from active lesions in a biopsy. They use a 4-5 mm punch to collect the sample.
PCR is also an important lab-based technique that helps detect leprosy. It can identify the DNAs of M. lepromatosis and M. leprae within the tissue. The sensitivity of the biopsy PCR test to leprosy is more than 90%.
A serological test is also a method to diagnose leprosy, but it is not as preferred as the other types of diagnoses because it is less sensitive. It may not produce results without the presence of histological and clinical evidence.
Various factors influence leprosy prognosis, including the stage or progress of the disease, access to treatment facilities, initiation of treatment after diagnosis, etc. You can completely cure the disease if you get the multi-drug therapy on time. You can also bypass extreme complications like neurological disability or deformity.
Nevertheless, there are also instances where people sustain partial to zero recoveries from loss of sensation or muscular debilitation. Furthermore, if the treatment process starts at an early stage, the chances of witnessing relapse or fatalities are also very unlikely.
Following are the different leprosy treatment procedures:
In chemotherapy, doctors generally prescribe different medications for leprosy, including dapsone, clofazimine and rifampicin, according to the symptoms of leprosy. Following are the benefits that use of these drugs provide:
Following are some of would care facilities that doctors may perform to treat wounds caused due to leprosy:
In case of severe extremities of neuropathy, it becomes important to follow the surgical process. Following are different surgical processes that a patient may have to undergo according to their medical condition:
Over 25% of the patients of leprosy encounter reactionary episodes of the disease in varying severity. This episode can occur before, after and during the treatment procedures. It does not develop due to the side effects of medication. Rather, these occur due to the existence of bacterial antigens within a patient’s body. The immune system reacts to those antigens, thereby showing the symptoms of reactionary episodes of leprosy.
Nevertheless, patients should not stop their ongoing medications due to the onset of reaction episodes. Further, doctors may recommend additional drugs, as mentioned below, to manage these episodes:
Clofazimine: It can also help a patient control the symptoms of reactionary episodes within a few weeks or months of continuous consumption. Nevertheless, high doses of clofazimine can cause gastrointestinal issues.
Here are some ways to help preventing the onset of Hansen’s Disease:
The vaccine initially made for TB, bacillus Calmette–Guérin (BCG), can generate protection against leprosy as well. Nevertheless, its effectiveness in leprosy may vary. Some countries also go with repeat vaccination of BCG for leprosy prevention. Studies have also established that repeat vaccination can enhance the protection against leprosy by 50% in comparison to the first dose.
The reason for the transmission of leprosy from one individual to another is unidentified. Still, the medical science fraternity believes that the transmission may result from droplets coming out from the coughs and sneezes of an affected person. These droplets contain leprosy bacteria. Prolonged and close contact with a patient may spread this disease to another healthy person.
This is why another prominent way to control the spread of Hansen’s disease is the contact tracing method. If individuals come in close contact with an affected person, they need to undergo an immediate medical examination. This way, they can determine whether they catch the disease.
It is also important that they undergo an annual diagnosis process. This way, there will be less chances of the transmission of leprosy from even a potentially affected person.
Following complications may arise if the symptoms of leprosy are severe:
Furthermore, the genetic variations caused due to the invasion of leprosy bacteria can also cause reactionary episodes. These reactions take place when the immune system responds to the dead bacteria within the body.
In India, the average cost of treating Leprosy is around Rs.27,000. The amount may hugely vary from one individual to another, depending on how long one needs to continue their treatment process. Some individuals may have to stay under the supervision of doctors and take the necessary medicines for up to years. Further, if individuals need to undergo the surgical process, it is quite natural that they will have to bear more expenses.
Some other factors that influence the overall cost of treating leprosy in India are as follows:
Leprosy is a medical condition, mainly a severe infection caused by Mycobacterium leprae and Mycobacterium leprom. You may develop symptoms like skin lesions, ulcers, swelling and patches on the skin, nervous issues, ocular problems, nosebleeds etc. However, it is possible to manage this infectious disease through multi-drug therapy or other treatment processes.
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Type 1 reactionary episode exacerbates inflammatory nerve trunks and skin lesions. As a result, patients may develop complications like motor or sensory alterations. The reaction can also lead to deformities or disabilities of the organ and morbidity.
Generally, patients with multibacillary leprosy become vulnerable to type 2 reactionary episodes of leprosy. They may develop painful erythema nodosum and fever. This type of reactionary episode can also cause inflammation like orchitis, iridocyclitis, lymphadenitis, nephritis, arthralgias, peripheral neuritis and periostitis.
The incubation period of leprosy ranges between 9 months and 20 years. Further, the average incubation period of tuberculoid and lepromatous leprosy are, respectively, 4 and 8 years.
Following are the steps of the wound management program to treat the wounds of leprosy: Assessment of the wound Treatment as necessary Protection from potential injuries Patient education to
You will be at a higher risk of developing Hansen’s disease if you come in prolonged contact with an untreated individual with leprosy. If your treatment process starts, patients do not spread this disease.
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