Leprosy

An infectious disease, known since Biblical times, which is characterized by disfiguring skin lesions, peripheral nerve damage, and progressive debilitation.

Alternative Names

Hansen's disease

Causes, incidence, and risk factors

Leprosy is caused by the organism Mycobacterium leprae . It is a difficult disease to transmit and has a long incubation period, which makes it difficult to determine where or when the disease was contracted. Children are more susceptible than adults to contracting the disease. Leprosy has two common forms, tuberculoid and lepromatous, and these have been further subdivided. Both forms produce lesions on the skin, but the lepromatous form is most severe, producing large disfiguring nodules . All forms of the disease eventually cause peripheral neurological damage (nerve damage in the extremities) manifested by sensory loss in the skin and weakness of the muscles. People with long-term leprosy may lose the use of their hands or feet due to repeated injury which results from absent sensation. Leprosy is common in many countries in the world, and in temperate, tropical, and subtropical climates. Approximately 100 cases per year are diagnosed in the United States. Most cases are limited to the South, California, Hawaii, and U.S. island possessions. Effective medications exist, and isolation of victims in "leper colonies" is unnecessary. The emergence of drug-resistant Mycobacterium leprae, as well as increased numbers of cases worldwide, have led to global concern about this disease.

Signs and tests

  • Lepromin skin test
  • can be used to distinguish lepromatous from tuberculoid leprosy, but is not used for diagnosis.
  • Skin scraping
  • examination for acid fast bacteria (typical appearance of
  • Mycobacterium leprae )

    Treatment

    Medications used to eliminate the microorganism and to reduce symptoms include:

  • Dapsone
  • Rifampin
  • Clofazimine
  • Ethionamide
  • Aspirin, prednisone, or thalidomide are used for the control of inflammation (e.g., "erythema nodosum leprosum") that may occur with therapy
  • Expectations (prognosis)

    Early recognition is important. Early treatment limits damage by the disease, renders the person noninfectious, and allows for a normal lifestyle.

    Complications

  • permanent nerve damage
  • cosmetic disfigurement
  • Calling your health care provider

    Call your health care provider if signs or symptoms described here occur, especially following exposure. Cases of leprosy in the United States need to be reported to the Centers for Disease Control and Prevention.

    Prevention

    Prevention consists of avoiding close physical contact with untreated people. People on long-term medication become noninfectious (they do not transmit the organism that causes the disease).

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