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Leprosy
Hansen disease
Leprosy is an infectious disease that has been known since biblical times. This disease causes skin sores, nerve damage, and muscle weakness that gets worse over time.
Causes
Leprosy is caused by the bacteria Mycobacterium leprae . It is not very contagious and has a long incubation period (time before symptoms appear), which makes it hard to know where or when someone caught the disease. Children are more likely than adults to get the disease.
Experts believe that the bacteria spread when a person breathes in tiny airborne droplets released when someone with leprosy coughs or sneezes. The bacteria may also be passed on by coming into contact with the nasal fluids of a person with leprosy. Leprosy has 2 common forms: tuberculoid and lepromatous. Both forms produce sores on the skin. However, the lepromatous form is more severe. It causes large lumps and bumps ( nodules ).
Nodules
Skin nodules are solid or cystic raised bumps in the skin that are wider than 1 centimeter (cm), but less than 2 cm.
Leprosy is common in many countries worldwide, and in temperate, tropical, and subtropical climates. About 100 cases per year are diagnosed in the United States. Most cases are in the south, California, Hawaii, and U.S. islands, and Guam.
Most people who come in contact with the bacteria don't develop the disease. This is because their immune system is able to fight off the bacteria.
Drug-resistant Mycobacterium leprae and an increased numbers of cases worldwide have led to global concern for this disease.
Symptoms
Symptoms include:
-
Skin lesions
that are lighter than your normal skin color
Skin lesions
Rashes involve changes in the color, feeling or texture of your skin.
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Lesions that have
decreased sensation
to touch, heat, or pain
Decreased sensation
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
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-
Muscle weakness
Muscle weakness
Weakness is reduced strength in one or more muscles.
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Numbness
or lack of feeling in the hands, arms, feet, and legs
Numbness
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
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Exams and Tests
Tests that are done include:
-
Skin lesion biopsy
Skin lesion biopsy
A skin lesion biopsy is when a small amount of skin is removed so it can be examined. The skin is tested to look for skin conditions or diseases. A...
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Skin scraping
examination
Skin scraping
A skin lesion biopsy is when a small amount of skin is removed so it can be examined. The skin is tested to look for skin conditions or diseases. A...
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The lepromin skin test can be used to tell the 2 different forms of leprosy apart, but the test isn't used to diagnose the disease.
Lepromin skin test
The lepromin skin test is used to determine what type of leprosy a person has.
Treatment
Several antibiotics are used to kill the bacteria that cause the disease. These include dapsone, rifampin, clofazamine, fluoroquinolones, macrolides, and minocycline. More than 1 antibiotic is often given together.
Aspirin, prednisone, or thalidomide is used to control inflammation.
Outlook (Prognosis)
Diagnosing the disease early is important. Early treatment limits damage, prevents a person from spreading the disease, and reduces long-term complications.
Possible Complications
Health problems that may result from leprosy include:
- Disfigurement
- Muscle weakness
- Permanent nerve damage in the arms and legs
-
Loss of sensation
Loss of sensation
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
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People with long-term leprosy may lose the use of their hands or feet due to repeated injury because they lack feeling in those areas.
When to Contact a Medical Professional
Call your health care provider if you have symptoms of leprosy, especially if you have had contact with someone who has the disease. Cases of leprosy in the United States are reported to the Centers for Disease Control and Prevention.
Prevention
People on long-term medicine become noninfectious. This means they do not transmit the organism that causes the disease.
References
Renault CA. Ernst JD. Mycobacterium leprae (leprosy). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 252.
Walker SL, Withington SG, Lockwood DNJ. Leprosy. In: Farrar J, Hotez PJ, Junghanss T, Kang G, Lalloo D, White NJ, eds. Manson's Tropical Diseases . 23rd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 41.
Review Date: 9/10/2015
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
