Alternate Names: Hansen disease
Causes and Risks: Leprosy is caused by the organism mycobacteria leprae. It is a difficult disease to transmit and has a long incubation period, which makes it difficult to determine where or when the disease was contracted. Children are more susceptible than adults to contracting the disease.
Leprosy has two common forms, tuberculoid and lepromatous. Although these have been further subdivided. Both forms produce lesions on the skin, but the lepromatous form is most severe, producing large disfiguring nodules. All forms of the disease eventually cause peripheral neurological damage (nerve damage in the extremities) manifested by sensory loss in the skin and weakness of the muscles. People with long-term leprosy often lose the use of their hands or feet.
Leprosy is common in many countries in the world, and in temperate, tropical, and subtropical climates. Approximately 270 cases per year are diagnosed in the United States. Most cases are limited to the South, California, Hawaii, and U.S. island possessions. Effective medications have made the existence of leper colonies unnecessary. Recently, the emergence of drug-resistant mycobacteria leprae has caused increased concern about this disease.
Prevention: Prevention consists of avoiding close physical contact with untreated people. People on long-term medication become noninfectious (they do not transmit the organism that causes the disease).
Symptoms: History of:
- exposure or family members with leprosy
- living or visiting areas of the world where leprosy is endemic (cases are known to occur in that area)
Symptoms include:
- one or more hypopigmented skin lesions that have decreased sensation to touch, heat, or pain
- skin lesions that do not heal after several weeks to months
- numbness or absent sensation in the hands and arms, or feet and legs
- muscle weakness resulting in signs such as foot drop (the toe drags when the foot is lifted to take a step)
Signs and Tests:
Treatment: Medications used to eliminate the microorganism and to reduce symptoms include:
- Dapsone (diaminodiphenylsulfone)
- Rifampin
- Clofazimine (a Phenazine dye)
- Thalidomide
Prognosis: Early recognition is important. Early treatment limits damage by the disease, renders the person noninfectious, and allows for a normal lifestyle.
Complications:
- permanent nerve damage
- cosmetic disfigurement
Call your health care provider if signs or symptoms described here occur, especially following exposure.
