Leprosy

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

• 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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