LEPROSY

• Leprosy


  Also known as Hansen's Disease / Hansenosis
• Leprosy


  • Chronic systematic infection characterized by progressive cutaneous lesions
  • Three distinct forms: Lepromatous, Tuberculoid, Borderline
• Lepromatous (Multibacillary) leprosy


  Most serious type<|>Not infectious<|>Causes damage to respiratory tract, eyes, testes, nerves, and skin<|>Lepromin test is negative, but skin lesions contain large amount of Hansen's bacillus<|>Slow involvement of peripheral nerves, with anesthesia, loss of sensation, and gradual nerve destruction
• Tuberculoid (Paucibacillary) Leprosy


  Affects peripheral nerves and sometimes surrounding skin, especially on face, eyes, testes, nerves, and skin<|>Lepromin Test is positive, but organism is rarely isolated from lesions<|>Macules are elevated with clearing at center and more clearly defined than lepromatous form
• Borderline (dimorphous) leprosy


  Has characteristics of both lepromatous and tuberculoid leprosy
• Etiological Agent


  Mycobacterium leprae
• Incubation Period


  Varies from a few months to many years<|>Lepromatous patients may be infectious for several years
• Mode of Transmission


  Airborne<|>Prolonged skin-to-skin contact
• Early Clinical Manifestations


  • Changes in skin color (reddish/white)
  • Loss of sensation on skin/Anesthesia
  • Decrease/loss of sweating and hair growth over lesion
  • Thickened/painful nerves
  • Muscle weakness
  • Redness of the eye
  • Nasal Obstruction
  • Ulcers that do not heal
• Late Clinical Manifestations


  • Madarosis (Loss of eyebrow and eyelashes)
  • Lagopthalmos (inability to close eyelids)
  • Clawing of fingers and toes
  • Contractures
  • Sinking of the nose bridge
  • Gynecomastia
• Diagnostic Tests


  • Slit skin Smear
  • Blood Test (Inc. RBC & ESR; Dec, Ca, albumin & Cholesterol level)
• Treatment Modalities


  • Sulfone Therapy
  • Rehabilitation, Recreational and Occupational Therapy
  • Multiple Drug Therapy: Multibacillary (Rifampicin, Clofazimine, Dapsone) - 12 months, Paucibacillary (Rifampicin and Dapsone) - 6-9 months
• Multibacillary leprosy


  Infectious type
• Paucibacillary leprosy


  Non-infectious types
• Nursing Management


  • Isolation and Medical Asepsis
  • Full, nutritious diet
  • Give antipyretic, analgesics and sedative as needed
  • Provide emotional support throughout treatment and rehabilitation
  • Patients with eye dryness need to use tear substitute daily and protect eyes
  • Advise patients with anesthetized leg to avoid injury
• Prevention


  • Report all cases and suspect of leprosy
  • BCG vaccine
  • Health education