Ques. 1 Describe Leprosy?
Ans. Leprosy (or Hansen’s disease) is a chronic infective Granulomatous disease due to a specific bacterial infection primarily of skin, mucous membrane and nerves.
The disease is transmitted through prolonged contact of a healthy person with patient. Spreads by direct contact or through the contaminated fomites. Causative organism is Mycobacterium Leprae. Children are more susceptible to leprosy than are the adults. Bacteria gain entrance into the human beings through the nasal mucosa or through skin.
Types : Two types –
- Tuberculoid, granuloma formation in the skin and nerves, less bacilli; giant cells, epitheloid cells are present, chronic course, less infectious.
- Cutaneous nodules; popular, and diffuse infiltrative lesions, plenty of lepra bacilli and lepra cell.
Cardinal signs of Leprosy:
- Thickened nerves.
- Presence of acid-fast bacilli (by examination of nasal scrapings or nodule under microscope).
- Diminution or loss of sensation.
Clinical features of Tuberculoid type:
- May be complete of partial loss of hairs in the involved area.
- Thickened cutaneous nerves may be associated with neuritic pain.
- Gradually wasting of the muscles of hand is noticed.
- In late stage, painless ulcer in the extremities, reabsorption of bone in distal part of hands and feet occur with the result of claw hands and claw feet.
- Spontaneous amputation of the digits.
- Enlarged lymph nodes.
- Lesions on the face are usually analgesic.
- Hypopigmented or erythematous dry (anhidropic) anaethetic or analgesic muscular patches in any part of the body.
Ques. 2 How can you manage a case of Leprosy?
Ans. Management :
- Surgical – (a) Lagophthalmos, temporalis muscles sling is done. (b) For claw hand, loss of adduction and flexion of the thumb and foot drop deformity – Free tendon grafts are done. (c) Trophic ulcer of the foot-best treated by excision of head and neck of the metatarsal over the ulcer. (d) The ‘saddle back’ deformity of the nose is treated with postnasal epithelial inlay graft. (e) For depilation of eyebrows, ‘inland flap skin, is employed,
- Conservative – Antileprotic drugs, viz. Diaminidophenyl sulpohne (D.D.S.) or Diaphenylthiourea (D.P.D).