Leprosy: Clinical Syndromes (Murray 3rd Ed pp 323)

Clinical features include:

• Muscle wasting, deformity, digital resorption, blindness, and digital loss due to trauma, burns. This type of leprosy is not easily transmissible. Transmission is though to be also by inhalation of infectious aerosols, and skin contact with respiratory secretions and wound exudates. M Leprae cannot be grown in cell free cultures, so diagnosis is confirmed by histopathogical findings, and clinical signs and symptoms.

Lepramatous (nodular)

This is when you have a strong antibody response and a weak CMI. The earliest sign of infection is presented by indeterminate leprosy – a inconspicuous macule. Macular lesions become raised (skin raised), nodular lesions appear in late stage lepramatous leprosy usually on face, ears.

Tuberculoid

Skin lesions are raised, macular or appear as rings and usually have a central healing part. The lesion is anaesthetic unless lesion is on the face. The peripheral nerve supplying the lesion may be enlarged (i.e.: ulnar, popliteal nerve etc). Tends to heal spontaneously but very slowly, often without later disability.

Borderline

This is not clear cut, but may have lesions in between lepramatous and tuberculoid.

Category: Microbiology Notes