LEPROSY

Leprosy is a chronic disease affecting skin and nerve. It is caused by Mycobacterium leprae. The clinical form of these diseases is determined by cell-mediated immunity. About 70 percent of the world’s leprosy patients live in India, Brazil, Indonesia.The medical complications of leprosy are due to nerve damage, immunological reactions and bacillary infiltration. Untreated leprosy patients discharge bacilli from the nose. Infection occurs through nose followed by haematogenous spread to skin and nerve. The incubation period is 2-5 years .There is three important aspects of leprosy pathogenesis, the spectrum of immune response, nerve damage and immune-mediated reactions. Patients commonly present with skin effects of a peripheral nerve lesion, weakness or an ulcer in an anesthetic hand or foot. Borderline patients may present with a reaction nerve pain, sudden palsy and new multiple skin lesions. It is most common cause of peripheral nerve thickening. Effective treatment can only be achieved with the patient’s cooperation and confidence. Educating leprosy patients about their disease is vital for successful management. All leprosy patients should be given an appropriate multidrug combination. Rifampicin is a drug which is given along with other anti-leprotics to cure this leprosy. The previous strategy of vertical leprosy has now been superseded by integrated programmes with primary health care workers in many countries now responsible for case detection.BCG vaccination has been shown to give good protection against leprosy