Leprosy is a bacterial infection causing skin sores, nerve damage and muscle weakness that deteriorates with time. This disease is curable and if treatment is initiated in the early stage, the severe disability can be prevented. There are several forms of leprosy that can range from the mild to the severe form. Based on the clinical manifestations, the types of leprosy include Indeterminate leprosy (IL) Tuberculoid leprosy (TT), Borderline tuberculoid leprosy (BT), Borderline borderline leprosy (BB), Borderline lepromatous leprosy (BL) and Lepromatous leprosy (LL). Depending on the immune response, an infected individual can remain in that stage, improve or become worse. Leprosy is most common in the wet and warm areas of the tropics and subtropics. It is estimated that around 80% of the cases are evident in the countries such as India, Myanmar, Brazil, Indonesia and Nigeria.
Causes
Leprosy is caused by the bacteria Mycobacterium leprae and has a long incubation period making it difficult to determine where and when the individual got the disease. Although the exact process of transmission is not completely understood, experts believe that the infection spreads when individuals breathe in airborne droplets that are released with coughing or sneezes of the infected person. The transmission is also possible with the contact of nasal fluids from the affected individual.
Symptoms
Leprosy affects the nerve, skin and the mucous membranes of the body. The symptoms associated with the skin include growths (nodules), discolored patches of the skin, thick dry skin, ulcers on the soles of the feet, loss of eyebrows or the eyelashes and the presence of lumps on the face or ear. When it affects the nerves, the symptoms can include numbness of the affected area, muscle weakness, paralysis of the hands and the feet, eye conditions that can result in blindness and enlarged nerves. The advanced signs of leprosy include blindness, nose disfigurement, paralysis, shortening of the digits and chronic ulcers on the feet that do not heal.
Diagnosis
The diagnosis is possible with the identification of the features that are characteristic of this condition such as the discolored patches of the skin. The diagnosis must be confirmed with various tests as these cases require the prolonged treatment with antibiotics. A skin biopsy or nerve biopsy can detect the characteristic feature of the skin and the involvement of the nerves. Depending on the type of leprosy, a special staining of the tissue can detect the bacteria.
Treatment
Leprosy can be cured. The focus of the treatment is to stop the infection and to minimize the physical deformities. Antibiotics are the initial course of treatment. Depending on the severity of the infection and the type of leprosy, the multidrug therapy may be initiated. Oral corticosteroids can prevent the nerve damage and reduce the swelling. Surgery may be required to improve the function of the affected parts of the body, to reconstruct the collapsed nose and to restore nerve function. Physical and psychological rehabilitation may be beneficial for some of the affected individuals.
References
http://www.who.int/mediacentre/factsheets/fs101/en/
https://www.niaid.nih.gov/diseases-conditions/leprosy-hansens-disease
http://www.dermnetnz.org/topics/leprosy
https://www.cdc.gov/leprosy/treatment/index.html
https://www.lepra.org.uk/lepra-and-leprosy
