Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: 1B20.Z

Hansen, 1874.

M. Hansen, Hansen`s disease, Morbus Hansen, Aussatz, leprosy, Hanseniasis, Hansen`s disease.

Chronic granulomatous infectious disease caused by Mycobacterium leprosum.

  • Occurring worldwide, but mainly in poorer countries
  • Approximately > ½ million new cases worldwide
  • Infection is increased in childhood and adolescence

  • Predisposition factors:
    • Deficient nutrition
    • Immune suppression
  • Pathogen: Mycobacterium leprosum
  • Incubation period: 3 to approx. 20 years
  • Transmission occurs through droplet infection, from skin to skin and via objects or breast milk

  • Comparison of lepromatous and tuberculoid leprosy
Lepromatous Borderline lepromatous Mid-Borderline Borderline tuberculoid Tuberculoid
Pathogen count ↑↑ ↓↓
Organic participation ↑↑
Nerve involvement (sensory disturbances ↓↓ (later) ↑↑ (earlier)
Number of lesions ↑↑ ↓↓
limitation symmetrical asymmetrical
Infiltration of the edges Unsharp Sharp
Hypopigmentation ↓↓ ↑↑
Surface Soft, glossy Scaly
Progression Progressive Cure
  • Multibacillary leprea = lepromatous, borderline lepromatous, mid-borderline, and borderline tuberculoid
  • Paucibacillary leprosy = tuberculoid, borderline tuberculoid

Source: Plewig, Gerd. Braun-Falco's Dermatology, Venereology And Allergology. Berlin: Springer, 2012. Print.

  • Check misperception of temperature, touch or pain (contralateral comparison is important)
  • Detect pathogens
  • Bact. swabs of the skin/mucous membrane (nose)
  • Biopsy from the lesion margin
  • Lepromin reaction: interesting for prognosis and classification
  • Histamine test: there is no erythema after intracutaneous injection of histamine
  • Sweat test: sweat secretion is absent in the area of the leprosy lesions
  • Serological detection of antibodies against PGL I antigen

  • Balanced diet
  • Improving hygienic conditions

  • Tuberculoid leprosy: favourable course
  • Lepromatous leprosy: unfavourable course
  • Secondary infections are the most common cause of death
  • Prophylaxis
    • Balanced diet
    • Improvement of hygienic conditions

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