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Leprosy
Published in Charles Theisler, Adjuvant Medical Care, 2023
Leprosy, also known as Hansen's disease, is a chronic infection of skin and peripheral nerves caused by Mycobacterium leprae. The main symptom of leprosy is disfiguring pale-colored skin sores, lumps, or bumps that do not go away after several weeks or months. If left untreated, signs of advanced leprosy can develop, which include crippling of hands and feet, shortening of toes and fingers due to reabsorption, a marked flattening of the nose, loss of eyebrows, and blindness.
Bacterial, Mycobacterial, and Spirochetal (Nonvenereal) Infections
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Overview: Leprosy is a chronic bacterial infection due to M. leprae, which manifests in different forms depending on the immune response of the host. It primarily affects the skin, mucous membranes, eyes, peripheral nervous system, and testes. It can affect all ages and is curable with early treatment avoiding morbidity. Historically, patients with leprosy were isolated, and the disease carried a strong negative social stigma. Transmission is thought to occur via droplet spread, and prolonged contact over many months is needed to contact the disease.
Non-erythematous lesions
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Leprosy is a chronic bacterial infection due to Mycobacterium leprae. It is spread by droplet infection and has a long incubation period (anything from 2 months to 40 years). It principally affects peripheral nerves and the skin. The clinical features are very variable depending on the patient's cell-mediated immunity to the leprosy bacillus.
Evolution of pediatric pharmaceutical forms for treatment of Hansen’s disease (leprosy)
Published in Expert Opinion on Therapeutic Patents, 2023
Jocimar da Silva Santos, Franciely da Costa Alves, Efraim José Dos Santos Júnior, José Lamartine Soares Sobrinho, Mônica Felts de La Roca Soares
First-line leprosy treatment is based on a multidrug regimen that incorporates chemotherapy and antibiotics such as rifampicin, clofazimine and dapsone, but in clinical practice other drugs are also used, such as bedaquiline, clarithromycin and minocycline. For both paucibacillary and multibacillary leprosy the WHO recommends the same therapeutic scheme, but it is required at least 6 months of treatment for patients diagnosed as paucibacillary and 12 months for multibacillary. The drugs are distributed in blisters at the point of use with specific packages for adults and children, differing only in dosages. Adults over 15 years old receive rifampicin (600 mg), clofazimine (300 mg) and dapsone (100 mg) once a month, plus clofazimine (50 mg) and dapsone (100 mg) once a day for all month. Children aged 10 to 14 years old receive rifampicin (450 mg), clofazimine (150 mg) and dapsone (100 mg) once a month, plus clofazimine (50 mg) and dapsone (50 mg) once a day for all month. Children or adults weighing between 30 to 50 kg receive rifampicin (450 mg), clofazimine (150 mg) and dapsone (50 mg) of once a month, associated with clofazimine in every other day (50 mg) and dapsone (50 mg) once a day. For children under 30 kg, body mass should be considered to calculate the required dosage. Even with WHO recommendations, some countries may incorporate their own complementary treatment criteria. However, because of the long treatment period, despite being effective, is considered unviable due to the complexity of the regimens and the number of daily doses administered [22,23].
Global epidemiology of leprosy from 2010 to 2020: A systematic review and meta-analysis of the proportion of sex, type, grade 2 deformity and age
Published in Pathogens and Global Health, 2022
Jing Yang, Xiang Li, Yanqi Sun, Lianhua Zhang, Guangjie Jin, Guoli Li, Shunyu Zhang, Kunchi Hou, Yunhui Li
Leprosy is an infectious chronic disease and a neglected tropical disease induced by Mycobacterium leprae, and mainly affects the skin, peripheral nerves, upper respiratory mucosa and eyes[1]. The prolonged physical deformities associated with leprosy get progressively worse with delayed diagnosis and increasing age [2]. While leprosy is a millennial disease, it is a public health and social issue of global concern prevalent in at least 122 countries [3]. The prevalence of leprosy declined from over 5 million cases in the 1980s to less than 129,192 in the late of 2020s [4]. This change was due to leprosy control around the world over the years. Based on the estimated new leprosy infections in 2020 published by World Health Organization (WHO), the top five countries, in sequence, are India, Brazil, Indonesia, Democratic Republic of the Congo, Bangladesh, and the proportion of newly detected leprosy cases with multibacillary leprosy was about 67.3%. In the meanwhile, 38.6% of the new leprosy cases were among females in the world. Considering that leprosy has still not been eradicated, it was essential to further investigate the epidemiological characteristics of leprosy.
Can anti-PGL-I antibody isotypes differentiate leprosy contacts and leprosy patients?
Published in Pathogens and Global Health, 2022
Andressa Almeida Albuquerque, Camilla dos Santos Mateus, Raphael de Oliveira Rodrigues, Évely Sampaio Lima, Lucas Oliveira Lima, Rayane Lima da Silva, Maria Amanda Mesquita Fernandes, Alexandre Casimiro de Macedo, Clódis Maria Tavares, Paula Sacha Frota Nogueira, Aparecida Tiemi Nagao-Dias
Another question that arises is why molecular tests are not used instead of serological tests. In our recent experience, virtually no blood samples from contacts were positive for M. leprae DNA, and only one patient’s blood sample was positive (unpublished data). Contacts cannot be biopsied for obvious reasons, and nasopharyngeal molecular testing has no association with disease. Therefore, we believe that among the best biomarkers with all their limitations are antibodies, considering not only the IgM isotype but also the main isotypes present in the systemic circulation and associating them with each other and perhaps other molecules of the immune system, such as chemokines. The important idea is that if we associate the isotypes, the probability of disease can increase. In conclusion, when faced with two or more positive antibody isotypes, we may already be closer to a real case of leprosy. This would certainly help in the diagnosis of leprosy.