Leprosy - Part 1 - a presentation at www.eyenirvaan.com

1. Pradnya Gogate B. Optom,
LEPROSY
PART 1
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2. LEPROSY
Hansen’s disease
Chronic, granulomatous
 Etiology: Mycobacterium leprae
 Male: Female ratio –2:1
 Transmission in nasal discharge, contact

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3. CLASSIFICATION

Tuberculoid

Lepromatous

Borderline/ Dimorphous
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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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8. LEPROMATOUS IRITIS
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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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11. PREVENTION

Avoid contact

Regular treatment

Follow up

Improve socio-economic conditions
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12. THANK YOU
CONTINUE TO PART II …
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