Leprosy: A Review of Epidemiology, Clinical Diagnosis, and Management

Abstract

Leprosy is a neglected infectious disease caused by acid-fast bacillus Mycobacterium leprae. It primarily affects the skin and then progresses to a secondary stage, causing peripheral neuropathy with potential long-term disability along with stigma. Leprosy patients account for a significant proportion of the global disease burden. Previous efforts to improve diagnostic and therapeutic techniques have focused on leprosy in adults, whereas childhood leprosy has been relatively neglected. This review aims to update the diagnostic and therapeutic recommendations for adult and childhood leprosy. This review summarizes the clinical, bacteriological, and immunological approaches used in the diagnosis of leprosy. As strategies for the diagnosis and management of leprosy continue to develop better and more advanced knowledge, control and prevention of leprosy are crucial.

Skin Lesions, Foot Drop, and Hand Contractures

“…2,10 The WHO recommends a 6-month course of dapsone, rifampin, and clofazimine for paucibacillary leprosy and a 12-month course for multibacillary leprosy. 2 Treatment with rifampin, moxifloxacin, and minocycline taken monthly for 12 to 24 months has similar efficacy, fewer adverse effects, and improved adherence compared with the WHO regimen but is 4 times more expensive. 5 Leprosy relapse rates after completion of WHO multidrug therapy are 0.77% for multibacillary leprosy and 1.07% for paucibacillary leprosy.…”

“…The clinical diagnosis of leprosy is based on the typical signs of skin lesions with hypoesthesia and nerve enlargement . Some patients may develop an immune response to M leprae , called a leprosy reaction, which presents as urticarial swelling of skin lesions, fever, neuritis, erythema nodosum, and permanent loss of motor and sensory nerve function . Leprosy reactions can occur before, during, or after treatment for leprosy …”

Bullous lepromatous leprosy mimicking bullous pemphigoid

“…1 The patient in this report, however, lives alone in a rural area in Tehama region where leprosy prevalence is extremely low and there are no known cases at the moment. He was a taxi driver and this is the most logical basis for her diagnosis (Chen et al, 2022). Skin biopsies and stain tests to confirm the M. leprae species available in the community hospital environment.…”

Genotyping of Mycobacterium leprae strains in south central coast and central highlands of Vietnam

“…PCR (polymerase chain reaction) is a genetic technique that can be used to detect the presence of M. leprae DNA in clinical samples, such as skin biopsies, slit skin smears, and nasal swabs. PCR can target various genes, including the RLEP gene, the 16S rRNA gene, the 18 kDa gene, and the gyrB gene ( 9 ). SNP (single nucleotide polymorphism) typing is a genetic technique that can be used to differentiate between different strains of Mycobacterium leprae.…”