Leprosy - Types, Symptoms, Causes, and Treatment

What Is Leprosy?

As reported by the World Health Organization (WHO), more than 200,000 cases of leprosy are detected each year around the world, with India having the highest incidence rate of the disease.

Leprosy, also called Hansen's disease, is an infectious disease that causes severe, disfiguring skin sores and nerve damage in the hands, legs, and areas of the skin around the body. Leprosy is caused by close contact with nose and mouth droplets from an infected person.

Leprosy has been discovered in animals in different locations across the world. On the American continent, armadillos are naturally infected with the bacteria that cause leprosy. Leprosy can spread from these infected armadillos to humans.

How Many Cases of Leprosy per Year?

It is estimated that about 250,000 new cases of leprosy are diagnosed worldwide every year. The condition is most common in India, Brazil, and other warm-climate regions. Children have a higher risk of getting leprosy than adults.

What Causes Leprosy and How Is It Spread?

Leprosy is caused by a slow-growing bacterium called Mycobacterium leprae (M. leprae). It may happen when a person with leprosy coughs or sneezes, and a healthy person gets infected through droplets containing the bacteria. The infection can spread through long-term contact with an infected person.

Leprosy is not caused by the following:

• Shaking hands or hugging.

• Sitting next to each other.

• Eating meals.

• Mother to her unborn baby during pregnancy.

• Sexual contact.

What Does Leprosy Look Like?

Leprosy mainly affects the skin, nerves, and mucous membranes (the soft, moist areas inside the body's openings). It usually takes three to five years for symptoms to appear after contact with the leprosy bacillus.

The disease may cause skin symptoms such as:

• A large, discolored lesion on a person's chest with leprosy.

• Skin patches that are discolored, flat, numb, and faded.

• Skin growths.

• Thick and dry skin.

• Painless ulcers on the soles of the feet.

• Painless swelling.

• Lumps on the face or earlobes.

• Loss of eyebrows or eyelashes.

Leprosy also causes nerve damage; symptoms may include:

• Numbness in the affected areas of skin.

• Enlarged nerves.

• Muscle weakness or paralysis.

• Eye problems that may lead to blindness.

• Enlarged nerves below the skin.

Symptoms when leprosy affects the mucous membranes:

• Stuffy nose.

• Nose bleeding.

What Are the Types of Leprosy?

The number and type of skin sores classify leprosy.

• Tuberculoid Leprosy: It is a milder form of leprosy. Tuberculoid leprosy is less infectious than other types. People with this type of leprosy have only one or a few flat and pale lesions (paucibacillary leprosy). The affected skin area becomes numb due to nerve damage beneath the skin.

• Lepromatous Leprosy: It is more severe and causes bumps and rashes (multibacillary leprosy), numbness, and muscle weakness. It affects the nose, kidneys, and male reproductive organs.

• Borderline Leprosy: People with this form of leprosy exhibit both tuberculoid and lepromatous symptoms.

The World Health Organization (WHO) Classification:

• Single Lesion Paucibacillary (SLPB): There is only one skin lesion.

• Paucibacillary (PB): There are two to five lesions. There is generally a loss of sensation in these areas.

• Multibacillary (MB): Six or more lesions. Multibacillary leprosy usually involves many cutaneous lesions, including damage and lumps under the skin (nodules). In addition, the moist tissues lining the body openings, such as the eyelids and the inside of the nose and mouth (mucous membranes), can also be affected, leading to vision loss, destruction of nasal tissue, or impaired speech.

How Is Leprosy Diagnosed?

Diagnosis of leprosy involves a physical examination of the skin and a biopsy of the skin or nerves. Tests of the blood and nerve or muscle function may be done to confirm a diagnosis. If your symptoms include those listed below, you will be diagnosed with:

• Tuberculoid (Paucibacillary) Leprosy - This type of leprosy is typically mild in nature and can include only a few patches of pale or red skin, as well as muscle weakness and/or lack of feeling in some areas.

• Lepromatous (Multibacillary) Leprosy - Lepromatous leprosy affects nerves, skin, and other organs, causing extensive sores and lesions.

• Borderline (Dimorphus) Leprosy - Borderline leprosy symptoms include those somewhere between the two types above.

How Is Leprosy Cured?

Leprosy is curable. Treatment depends on the type of leprosy someone has. Leprosy medication usually includes antibiotics. Doctors recommend long-term treatment, typically for 6 months to 1 year. Severe forms of leprosy may require antibiotics for longer than other forms.

• Leprosy medication includes multidrug therapy (MDT), the most common leprosy treatment that combines antibiotics.

• Anti-inflammatory drugs are taken to control nerve pain and damage related to leprosy. These drugs include steroids like Prednisone.

• Leprosy medication also includes Thalidomide. It suppresses the immune system and helps treat skin nodules. Thalidomide is never taken in pregnancy as it is known to cause severe, life-threatening congenital disabilities.

What Is Armadillo Leprosy?

In the southern United States, armadillos carry the bacteria that cause leprosy. There are many chances for the occurrence of armadillo leprosy. However, the risk of armadillo leprosy is low, and people are less likely to become infected. If the people decide to have the meat, it should be undercooked. Through cooking, the armadillo will destroy the bacteria it carries.

What Are the Complications of Leprosy?

Leprosy can permanently damage the skin, nerves, arms, legs, feet, and eyes if left untreated.

The complications of Leprosy may include,

• Blindness or glaucoma.

• Iritis.

• Hair loss.

• Infertility.

• Face disfiguration.

• Erectile dysfunction.

• Kidney failure.

• Muscle weakness that leads to claw-like hands.

• Nosebleeds and a chronic stuffy nose due to permanent damage to the nose.

• Permanent nerve damage outside the brain and spinal cord leads to loss of feeling.

How Is Leprosy Prevented?

The best method of preventing leprosy is to avoid contact with secretions in the form of droplets from individuals with leprosy. As recommended by the World Health Organization (WHO), leprosy can be prevented using the SDR-PEP (single-dose Rifampicin post-exposure prophylaxis) method.

SDR-PEP involves the administration of a single-dose Rifampicin to close contacts of individuals who have been diagnosed with leprosy following appropriate screening. It has been proven that a single dose of Rifampicin can greatly minimize the chance of developing the infection.

What Are the Risk Factors Associated With Leprosy?

The most common risk of leprosy is getting in contact with someone who is already infected with leprosy. Compared to the normal population, people who have encountered the infected person have a five to eight times higher risk of leprosy.

Certain conditions can increase the risk of leprosy, including malnutrition, genetic mutations, and other illnesses. Some genetic factors are known to predispose a person to leprosy. Certain genetic conditions can cause tuberculosis or lepromatous leprosy.

Conclusion

Leprosy is an infectious disease caused by a slow-growing bacterium called Mycobacterium leprae. It can affect the nerves, skin, eyes, and nasal mucosa. Leprosy was once considered a highly contagious and devastating disease, but now it does not spread easily, and treatment is very effective.

However, leprosy can permanently damage the skin, nerves, arms, legs, feet, and eyes if left untreated. However, with early diagnosis and treatment, it is possible to cure the disease completely. People affected by leprosy can have a normal lifestyle during and post-treatment. To get more detailed information, consult the specialist.

Keytakeaways

• According to the World Health Organization, there are over 200,000 cases of leprosy diagnosed annually worldwide.

• Leprosy is an infectious disease caused by the bacterium Mycobacterium leprae.

• The bacteria are transmitted through nasal and oral droplets due to prolonged contact with untreated patients.

• Leprosy is curable using MDT treatment. The largest number of new cases each year comes from Southeast Asia.