Main » Infectious diseases » Infections Acquired through the Skin and Mucous Membranes » Leprosy
Leprosy is particularly common today in Africa, the Indian subcontinent, Southeast Asia and South America. (Rates per 1000 shown on figure).
Distribution of leprosy.
Photo 1. Preparation of skin smear. A biopsy from a nodule will be smeared and stained with Ziehl-Neelsen stain.
Photo 2. Preparation of skin smear (2).
Photo 3. Preparation of skin smear (3).
Photo 4. Organisms in skin biopsy stained by TRIFF method. Mycobacterium leprae is an acid and alcohol fast organism readily seen in sections (4) or smears (5) of the skin of leprornatous patients. (x 100) (x 600)
Photo 5. Organisms in skin biopsy stained by TRIFF method (smears).
Photo 6. Lempromin test.
The 'Mitsuda' reaction, usually attains its maximum in four to five weeks and indicates the degree of sensitivity to the mixture of antigens (leprosy bacilli) injected. The reaction is expressed in mm with or without ulceration and is read about the 21st day after injection. In patients with lepromatous leprosy the reaction is completely negative. In patients with tuberculoid leprosy it is variably positive.
Photo 7. Early macules. An early sign of leprosy, the indeterminate macule, is slightly hypo-pigmented and ill-defined. It retains tactile-sensitivity, sweating function, and hair growth.
Photo 8. Tuberculoid leprosy. The early tuberculoid lesion is characterised by macules showing loss of sensation and hypopigmentation.
Photo 9. Ulnar nerve lesion. Damage to the ulnar nerve in tuberculoid leprosy leads to weakness and wasting followed by complete paralysis, and atrophy of the ulnar- innervated hand muscles, resulting in the characteristic picture of the 'main de prédicateur'.
Photo 10. Loss of extremities in late tuberculoid leprosy. Neurotrophic atrophy eventually leads to the loss of phalanges, especially following trauma resulting from the anaesthesia. This man shows almost complete loss of hands and feet.
Photo 11. Nerve thickening. Thickening of the great auricular nerve is also common in tuberculoid leprosy.
Photo 12. Lepromatous leprosy. Leprornatous leprosy, showing extensive infiltration, oedema and corrugation causing 'leonine facies'. Note dépilation of eyebrows and face, and thickening of ear.
Photo 13. Lepromatous nodule in eye. Leprosy is a common cause of blindness in the tropics.
» Lymphogranuloma venereum
» Herpes simplex
» Mycobacterium ulcerans and Other Tropical Ulcers
» Granuloma Inguinale (Donovanosis)
» Non-venereal Treponematoses
» Primary Amoebic Meningo-Encephalitis
» The superficial mycoses
» The systemic mycoses