4. TUBERCULOID
Benign
Distribution:
Face, skin, gluteal region,
limbs
Asymmetrical lesions, anhydrotic
Polyneuritis
Claw hand, foot drop
Nerves involved Eg. Ulnar, peroneal
Loss of sensation
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5. LEPROMATOUS
Macular, diffuse nodular
Distribution: Face, ear lobes, neck, extremities, trunk
Borderline
Intermediate between lepromatous & tuberculoid
Bizarre skin lesions (eyes, nose)
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6. LEPRA REACTIONS
Inflammation in pre-existing lesions
Type I: Borderline & tuberculoid
Mechanism: Cell mediated
hypersensitivity
Occurs spontaneously, loss of nerve
function,
swollen skin lesions
Type II: Common in 2nd year of treatment
Fever, painful papules/nodules(erythema
nodosum leprosum)
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7. OCULAR FEATURES
Conjunctivitis
Keratitis
Loss of eyelash/ eyebrows
Scleritis
Corneal anaesthesia
Iritis (lepromatous)
Severe miosis, iris atrophy
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9. INVESTIGATIONS
Slit skin smear: Lesions from ear lobe,
ring/middle finger
Lepromin test (suspension of dead M.leprae)
Classify disease, determine prognosis/treatment
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10. MANAGEMENT
Isolation
of patient till non-infectious
Three drug therapy:
Rifampicin
Clofazimine 50mg/day
Dapsone 2mg/kg/day
Chemotherapy for lepra reactions:
Thalidomide 100mg/6hrs
Aspirin 600mg/6hrs
Steroids
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