Leprosy Review

BACKGROUND: Clinical data on pure-neuritic leprosy (PNL) is limited. OBJECTIVE: To study the clinical and epidemiological features of PNL in the leprosy post-elimination era. METHODS: This was a retrospective analysis of the clinic records of leprosy patients from January 2006 to June 2013. Data regarding age, sex, disease duration, presenting complaints, nerves affected, complications and treatment received were extracted from PNL cases. RESULTS: Among 906 registered leprosy cases, 48 (5·3%) were found to have PNL...

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Disability due to leprosy often lasts lifelong, so estimates of the burden of leprosy in a community based on ‘registered prevalence of leprosy cases’ or on ‘proportion with Grade 2 disability amongst new cases in past year’ will seriously underestimate the number of disabled people in the community needing support or services. In a previously highly endemic are of Bangladesh, the accumulated prevalence of disability due to leprosy amongst adults was 45·35/100,000 population.

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Leprosy, a disease of skin and peripheral nerves has varied manifestations which principally affect the immune status of the host. Leukemic skin infiltrations in patients with leukemia are referred to as leukemia cutis. It can be seen in all types of leukemia, especially in patients with acute myelomonocytic leukemia (AML). In majority of cases, the cutaneous lesions are nonspecific manifestations associated with an impaired immune system.1 Though various malignancies have been documented with leprosy, no case of borderline-tuberculoid (BT) Hansen’s disease with coexisting leukemia cutis has ever been reported in literature to the best of our knowledge...

Leprosy has been labelled as a great imitator since times immemorial. This mainly is because of the wide range of its clinical presentations. In endemic regions it is important to entertain the possibility of leprosy even in atypical presentations so as to avoid misdiagnosis. Here we report three cases of leprosy with uncommon disease presentations. First case had presented with eczematous morphology of cutaneous lesions without sensory loss and nerve thickening. Second case had localized type-2 reaction and third case had presented initially with only rheumatologic manifestations...

A 26 year old male, treated case of lepromatous leprosy, presented with severe heat intolerance, loss of sensation and sweating over distal parts of both upper and lower limb of 12 years’ duration. On examination, there was definite sensory loss over the extremities in glove and stocking pattern and thickening of the bilateral ulnar, common peroneal and radial nerves. There were three trophic ulcers over the plantar aspect of the right foot, atrophy of the small muscles of hand, reabsorption of the distal index, middle and ring fingers along with total clawing of both hands...

Background: Thalidomide is well known as a steroid sparing drug in Erythema Nodosum leprosum (ENL) reaction in leprosy. There is no guideline as to when it should be offered to patients. Documentation of ENL presentation with its morbidity before and after with patient profile can be a baseline to develop a selection criteria as to when thalidomide should be started to reduce steroid related morbidly. Method: Chart and electronic record review was done. Result: 427 ENL patients attended the hospital from 2010 to 2014...

To investigate the relationship between the WHO disability grading system for leprosy with the limitations to perform daily functional activities and the decrease in social participation in participants with leprosy. Participants with a diagnosis of leprosy were recruited at the dermatology ambulatory clinic of the University Hospital of Sergipe. In order to investigate the association of WHO disability grading system for leprosy with activities of daily living measured with the Screening Activity Limitation and Safety Awareness (SALSA) scale and with the social participation (P-scale), we performed an analysis with the Kruskal-Wallis test and the Spearman coefficient...

Background: India achieved the goal of ‘leprosy elimination’ by reducing the burden of leprosy to less than one case per 10,000 inhabitants in 2005. Sustained and committed efforts by national programmes have led to a decline in the burden of leprosy to a great extent. Purpose: To examine the spatial clustering of leprosy case detection and spatiotemporal trend using Bayesian space period model. Materials: The National Leprosy Eradication Programme (NLEP) data of annual new case detection of leprosy in 34 districts of Maharashtra for eight data years 2007–08 to 2014–15...

Introduction: Duration of leprosy treatment remains long and difficult to complete in resource poor areas. Studies suggest that shortening duration of therapy for MB patients to 6 months may be possible. Methods: New MB patients in 2005 in two NGO projects in Bangladesh were treated with 6 months WHO MB MDT and the rate of relapse and fall in BI on slit skin smear during follow up to date were compared with a control group treated for 12 months the previous year...

New cases of leprosy indicate that M. leprae transmission is continuing. In the first half of 2015 we sequentially diagnosed new leprosy patients attending Cebu Skin Clinic, a referral and leprosy treatment centre in Cebu City, Philippines. The great majority of patients were characterised as multibacillary (145 of 147; 98·6%), most of whom had bacterial indices 3þ (86; 58·5%) or more than 20 skin lesions (94; 63·9%). Importantly, 65·3% estimated that slightly over a year had elapsed between their initial symptoms and diagnosis, while 26·5% reported a lapse of greater than 3 years...

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INTRODUCTION: Recommended fixed duration prednisolone regimen was not found effective in the treatment of chronic neuritis. Alternate effective treatment was being sought to reduce the deformity in the field of leprosy. OBJECTIVE: We wished to see whether a prolonged course of prednisolone and methotrexate could be of any help for them. METHODOLOGY: In 2012-2014, an open pilot clinical study was undertaken where three chronic neuritic patients were treated with lower doses prednisolone and methotrexate for 12 months and a follow up period was delivered for 12 months...