Leprosy - Symptoms, Causes, Treatment and Prevention

Also known as Hansen’s disease, Leprosy is a kind of skin infection that is caused due to bacteria called Mycobacterium leprae, which causes a progressive, chronic bacterial infection called leprosy. The nerves in the nose’s lining, the upper respiratory tract and in the extremities get affected by it.

Leprosy produces nerve damage, muscle weakness and skin sores. If not treated, it may result in significant disability and severe disfigurement. Leprosy is quite common in lots of countries, especially those having subtropical or tropical climates.

Generally, Leprosy is categorized into three types:

• Tuberculoid leprosy: This type of leprosy causes asymmetric solitary skin lesions with demarcated edges. There are also chances of early and marked nerve damage. Tuberculoid leprosy tends to heal spontaneously.
• Lepromatous leprosy: Lepromatous leprosy is more severe than Tuberculoid leprosy. It causes muscular weakness, skin rashes, and bumps. It is considered more contagious than Tuberculoid leprosy and can also kidney, nose, and more reproductive organs.
• Borderline leprosy: It is a cutaneous skin condition with red, irregularly shaped multiple skin lesions.

According to WHO, Leprosy is divided into:

• Paucibacillary: It has lesser lesions with no presence of bacteria.
• Multibacillary: It involves more skin lesions with the presence of bacteria.

Ridley-Jopling classification: It includes five categories of leprosy:

• Tuberculoid leprosy: People who suffer from tuberculoid leprosy have white patches on the skin and the skin becomes pale in color. The area which gets affected losses sensation as the nerves are damaged.
• Borderline Tuberculoid leprosy: The symptoms of Borderline Tuberculoid leprosy and tuberculoid are the same but the infection continues and it may also advanced.
• Mid-borderline leprosy: In this, the symptoms are similar to borderline tuberculoid leprosy. In this, on the skin, there are reddish plaques along with which can also take any other form or shape.
• Borderline leprosy: In this stage, there are multiple types of wounds and scars on the skin and it is also known as a cutaneous skin condition.
• Lepromatous leprosy: This is one of the most severe types of leprosy and is caused by a number of lesions bacteria. The region which gets affected is full of bumps, that part also becomes numb and rashes.

Symptoms might not show up till 20 years. The doctor can carry out a physical examination to search for symptoms and telltale signs of the disease. The symptoms of leprosy include the following:

• Skin lesions
• The weakness of the muscles
• Numbness of the hands, feet, arms, and legs.
• Primarily the skin and nerves are attacked during this disease and the skin gets disfigured as there are a number of lumps, sores, and bumps on the skin.
• But if the person gets infected by the bacteria which causes leprosy symptoms will be seen after 3-4 years as it is a progressive disease and the incubation period of the bacteria is also very long.
• Though skin is the main organ that is damaged leprosy also damages the nervous system of the body which includes sensory nerves, eye nerves, motor nerves, and autonomic nerves.

The main cause of leprosy is Mycobacterium leprae which is a kind of bacteria. It is a kind of slow-growing bacteria and was discovered by M. leprae.

Leprosy can spread from one person to another by droplets which can be nasal secretion or through sexual activity. Its effects are not seen soon after as it is a progressive disease and takes ages to reflect properly.

Leprosy is a contagious skin infection that spreads through contact with an infected person’s body fluids and rashes. As the incubation period of the bacteria causing Leprosy i.e mycobacterium leprae, varies usually between two to ten years, the duration for which an infected person remains contagious is 5 years on average. However, the duration may extend up to 20 years in some cases.

These are the risk factors for leprosy:

• The biggest risk of leprosy is that is spreads from one person to another. Therefore people who live with or near the people affected with leprosy are at the highest risk.
• People suffering from malnutrition can get affected by leprosy.
• If a person has a weaker immune system then he/she also gets affected by leprosy as the body does not have any power to fight against the bacteria.
• If a person is suffering from HIV and along with that gets affected by leprosy then the condition gets worse as they start getting antiviral treatment.

The doctor can carry out a physical examination to search for symptoms and telltale signs of the disease. They also carry out scraping or skin biopsy.

The doctor removes a small part of the skin and sends the sample to the lab for testing. They might even conduct lepromin test of the skin for determining the kind of leprosy.

The doctor injects a tiny amount of leprosy inducing bacteria in the skin, usually in the upper part of the fore arm. People having borderline tuberculoid or tuberculoid leprosy have irritation at the site of injection.

The treatment of leprosy is dependent upon antibiotics and it is the only means used for the treatment. If a person is suffering from leprosy then he/she is given MTD that is multi-drug treatment and the drugs are never used as monotherapy or single.

The infection is treated with the help of antibiotics and if the treatment is long term and the duration extends from six months to one year then two or more antibiotics are used.

But antibiotics can only treat the damaged skin and not the damaged nerves. The use of anti-inflammatory drugs is also done in order to treat the infection, pain, and inflammation during leprosy. Some steroids are also used which includes prednisone.

Patients who suffer from this disease mostly experience a weaker immune system thus thalidomide is given to make the immune system stronger. This helps in the treatment of leprosy skin nodules.

The World Health Organization has come up with a multiple drug therapy for curing all kinds of leprosy. It is available worldwide for free of cost. Quite a few antibiotics are also available for killing the leprosy causing bacteria. Your doctor might prescribe multiple antibiotics at once. The antibiotics are:

• Dapsone
• Rifampin
• Minocycline
• Ofloxacin
• Clofazamine

Vaccines have been discovered so far for the prevention of Leprosy. BCG i.e Bacillus Calmette Guerin vaccine has been promoted as a preventive measure against the disease. However, the efficacy of the vaccine is somewhat different as compared to the efficacy in the case of tuberculosis which also considers the same vaccine as preventive measures.

These are the complications that a person who is suffering from leprosy can have:

• Disfigured organs which include the face, hands, legs or any other part
• Glaucoma or blindness
• Failure of kidney
• Infertility in men and erectile dysfunction
• The weakness of the muscles which leads to a number of difficulties
• Permanent damage of nose which includes nose bleeding, and stuffy nose
• Permanent damage to the nerves which are present outside the brain and spinal cord. This also includes nerves in the arms, legs, and feet.

There is no exact prevention for this disease as it spreads through nasal droplets therefore to avoid leprosy you should avoid close contact with the person who is suffering from leprosy and is prone to the infection.

Summary: Leprosy is no longer something to fear. The disease is rare. It's also treatable. Most people lead a normal life during and after treatment.

One of the causes for the development of Leprosy is inadequate and improper consumption of food, which leads to deficiency of nutrition in the body of the affected individual. This results in the weakening of the immune system which makes the body more prone to infection. Food items that should be preferred to be taken include fresh fruits and vegetables, milk, eggs, meat, fish, etc.

Summary: Leprosy is a chronic contagious skin infection that spreads through contact with an infected person’s body fluids and rashes. It can be cured by certain medications such as Dapsone, Rifampicin, and Clofazimine. However, the preventive measures include vaccination. BCG i.e Bacillus Calmette Guerin vaccine is usually preferred in the condition.