Leprosy PDF

LEPROSY PRESENTED BY OBY INTRODUCTION Leprosy is a chronic infectious disease caused by a bacteria called Mycobacterium Leprae, mainly causing skin lesions& nerve damage. This results in loss of sensation, leading to loss of parts of a person’s extremities from repeated injuries or infection throu...

LEPROSY PRESENTED BY OBY INTRODUCTION Leprosy is a chronic infectious disease caused by a bacteria called Mycobacterium Leprae, mainly causing skin lesions& nerve damage. This results in loss of sensation, leading to loss of parts of a person’s extremities from repeated injuries or infection through unnoticed wounds. It is one of the oldest disease known to man. SOURCES OF INFECTION The source of infection is the infected person. Nasal discharge, skin lesions & close contact with untreated patients lead to the transmission of the infection.  The bacteria enters the host body via 2 entry points; skin& upper respiratory tract. Upon entry, it localizes in te skin, peripheral nerves & nasal mucosa of the host. The bacilli primarily affects the schwann cells in the peripheral nerves leading to nerve damage, demyelination & Pathogenesis development of disability. This bacilli is bad news as it has long and variable incubation period, which can be a few weeks or maximum of 10-40 years. The bacteria has an affinity towards cooler areas of the body; mucous membrane of the nose, anterior chamber of eye, ear lobes, cartilages, testes e.t.c CLASSIFICATION OF LEPROSY There are two main classification of leprosy: 1. W.H.O classification; it is based on the involvement of nerves and skin lesions into 2 types: a) Paucibacillary: no or 1 nerve trunk involved with maximum of 5 skin lesions. b) Multibacillary: involvement of more than 1 nerve trunk & 5 skin lesions. 2. Ridley & Jopling classification: this bases upon clinical & histological findings. Leprosy is divided into 5 a) Tuberculoid (TT) b) Borderline tuberculoid (BT) c) Borderline (BB) d) Borderline lepromatous (BL) e) Lepromatous (LL)  Damage of the limbs without loss of sensation due to other reasons like injury, accidents, burns, birth defects or due to other diseases like arthritis or What is not conditions causing paralysis Skin patches with normal leprosy feeling, present from birth, are white, black, dark red. Skin patches that show scaling, appear and disappear periodically and spread quickly.  CLINICAL FEATURES/ SYMPTOMS Clinical presentation depends on the patient's immune status at the time of Late stage infection and during the course of the disease.  Trophic ulcer Early stage  Foot drop/ claw toes  Hypopigmentation/skin lesions  Loss of digits  Sensory loss at the skin lesion is a must  Muscle weakness  Sensory loss in the digits  Dry scalp  Thickened nerves  Nasal bridge collapses leading to flat or runny nose  Limb deformity  Blindness Hair loss Infertility Kidney failure Erectile dysfunction COMPLICATIONS Drop wrist Muscle weakness Paralysis Disfiguration of the face  Multi-drug therapy Physiotherapy MANAGEMENT Occupational therapy Patient counselling Surgical approach Sensory care  Early diagnosis and treatment of people who are infected BCG vaccination for infants in Prevention endemic regions Offering chemoprophylaxis(administration of a medication for the purpose of preventing disease or infection) to healthy household contacts  Skin slit smear Lepromin test Skin biopsy Diagnosis M. Leprae DNA PCR; for detecting the leprosy organism  Care for leprosy complications Use thick cloth or gloves for insulation when handling hot objects to protect insensate hands. Use tools with wooden or rubber-covered handles to help prevent injury. Use grip aids and splints to protect hands. Wear appropriate footwear to protect insensate feet. Use appropriate footwear to help prevent plantar ulcers. Soak a palm or sole with sensory loss for 20 minutes in cool clean water to make the skin supple. Then rub off the hard skin with a scrapper stone, which keeps the skin soft. Oil the wet skin to help retain moisture and prevent dryness. Include inspecting as well as soaking, scraping, and oiling in the self-care routine to help the early detection of issues. Inspect the anaesthetic area for injuries, or even red spots, swelling, and cracks and take adequate precautions to prevent the wound from becoming bigger. Treat simple wounds at home by bandaging with a clean cloth. A wound area on the hand should be rested; one on the foot should be offloaded. Immediately report any signs of infection to the physician for further management.