Leprosy — photos

Symptoms and syndromes in photos

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.

Distribution of leprosy.

Preparation of skin smear.

Photo 1.  Preparation of skin smear. A biopsy from a nodule will be smeared and stained with Ziehl-Neelsen stain.

Preparation of skin smear (2).

Photo 2.  Preparation of skin smear (2).

Preparation of skin smear (3).

Photo 3.  Preparation of skin smear (3).

Organisms in skin biopsy stained by TRIFF method.

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)

Organisms in skin biopsy stained by TRIFF method (smears)

Photo 5.  Organisms in skin biopsy stained by TRIFF method (smears).

Lempromin test.

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.

Early macules.

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.

Tuberculoid leprosy.

Photo 8.  Tuberculoid leprosy. The early tuberculoid lesion is characterised by macules showing loss of sensation and hypopigmentation.

Ulnar nerve lesion.

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'.

Loss of extremities in late tuberculoid leprosy.

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.

Nerve thickening.

Photo 11.  Nerve thickening. Thickening of the great auricular nerve is also common in tuberculoid leprosy.

Lepromatous 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.

Lepromatous nodule in eye.

Photo 13.  Lepromatous nodule in eye. Leprosy is a common cause of blindness in the tropics.

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