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Leprosy

Kevin C. Shannon, MD, MPH, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A chronic, inflammatory granulomatous infection (caused by Mycobacterium leprae, a slow-growing, acid-fast bacillus), preferentially affecting cooler regions of the body (e.g., skin,...

DIAGNOSIS

HISTORY

  • Known or suspected contact with leprosy

  • Skin lesions and/or enlarged nerves accompanied by sensory loss

  • Ulcers in anesthetic feet are the most common cause of hospitalization.

PHYSICAL EXAM

TREATMENT

GENERAL MEASURES

  • Multidisciplinary approach, including orthopedic surgery, ophthalmology, and physical therapy in addition to specific drug therapy

  • Rigid-soled footwear, walking plaster casts,...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Frequent follow-up visits until therapy is stabilized and then monthly supervision

  • Drug toxicity uncommon after 1st year of treatment

  • CBC, renal, ...

REFERENCES

1
George Priya Doss C, Nagasundaram N, Srajan J, et al. LSHGD: a database for human leprosy susceptible genes. Genomics.  2012;100(3):162–166. [View Abstract on OvidMedline]
2
Lu'o'ng Kv,...

ADDITIONAL READING

  • Merle CS, Cunha SS, Rodrigues LC. BCG vaccination and leprosy protection: review of current evidence and status of BCG in leprosy control. Expert Rev Vaccines.  2010;9(2):209–2...

CODES

ICD10

  • A30.9 Leprosy, unspecified

  • A30.0 Indeterminate leprosy

  • A30.1 Tuberculoid leprosy

  • A30.3 Borderline leprosy

  • A30.2 Borderline tuberculoid leprosy

  • A30.4 Borderline lepromatous leprosy

  • A30.5 Lepromato...

CLINICAL PEARLS

  • Most humans (95%) are not susceptible to leprosy.

  • There are no serologic or skin tests for screening or early diagnosis of leprosy before physical signs are present.

  • In suspected cases, ...

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