1. LEPROSY (Hansen’s Disease)

2. Causative Organism- Mycobacterium
leprae
Affects mainly cooler parts of the body
Skin, mouth, Respiratory Tract, eyes,
Peripheral nerves, Testis, etc
Earliest Skin & Nerves

3. PATHOGENESIS Acid fast, obligate intracellular organism
Poor growth in culture, but grows in
armadillo, foot pad of mice
Virulence– cell wall properties
Cell mediated immunity– Lepromin Test

5. DIAGNOSIS Split skin smears & nasal smears
AFB ( Ziehl – Neelson) stain
Fite Faraco Stain
Silver stain

6. Bacteriological Index
Morphological Index
Solid staining – Live
Fragmented / Beaded - Dead
Paucibacillary – No Bacilli
Multibacillary – Some or many Bacilli

7. TRANSMISSION
? Inhalation
Direct Contact
Maternofetal transmission

8. Classification 2 Main types ( polar forms); Lepromatous – Low Immunity
Tuberculoid – High Immunity

9. Modified Ridley Jopling’s Classification
Indeterminate
TT – Tuberculoid
BT – Borderline Tuberculoid
BB – Mid Borderline
BL – Borderline Lepromatous
LL -- Lepromatous

10. FEATURES TT LL
Skin Lesions
Asymmetrical
Symmetrical (Leonine Facies)
Nerve Involvement
+, Sensory disturbance ++
Sensory disturbance
Foam Cells, ‘Grenz Zone’ +
Microscopy
Tubercle, ‘Grenz Zone’ -ve
Bacilli load
‘Globi’ / cigarette pack
Few are seen
Immunity
High
Low
Lepromin Test + -

13. Tuberculoid Leprosy

14. Tuberculoid Leprosy:
Skin lesions
Nerve lesionsAnaesthesia, Skin & muscle atrophy, Trophic ulcers, Contractures,etc
MC – Ulnar, Radial, Common peroneal
VII Cranial nerve Keratitis, Corneal ulcer

15. Lepromatous Leprosy:
Widespread invasion of shwann cells, neural macrophages
GlobiAggregates of foam cells filled with masses of AFB
Macules, Papules,Nodules Leonine Facies
Testes- Extensive destructionSterility

22. REACTIONS IN LEPROSY Type I ( Reversal Reaction) Upgrading Reaction
Downgrading Reaction
Type II ( Erythema Nodosum Leprosum)
Usually after chemotherapy
Occurs in LL
Tender nodules, Iridocyclitis, Lymph node
involvement
Infiltration of neutrophils, Vasculitis
Responds to Treatment

23. Thank You