LEPROSY Represented by Nirjesh Kumar B.Pharm 4th Year

MAHATMA GANDHI INSTITUTE OF PHARMACY

Leprosy(Hansen’s Disease)

CONTENT

Leprosy Introduction Singh and symptom Transmission Diagnosis Treatment References

What is Leprosy?

It is a chronic infectious disease characterized by lesions of the peripheral nerve, skin,

and mucus membrane of the URT. World's oldest recorded disease Stigmatized disease

Every year January 27 is World Leprosy Day

IntroductionA chronic infectious disease caused by the bacterium Mycobacterium leprae .

Gerhard Henrik Armauer Hansen was a physician which first identified Mycobacterium leprae as the cause of leprosy in 1873 .

What are the types of leprosy?

○ Lepromatous: damages respiration, eyes, and skin (Paucibacillary Leprosy (PB)

○ Tuberculoid: affects nerves in fingers and toes, and surrounding skin (Multibacillary Leprosy (MB)

How the human body is affected by Leprosy

Nerve is damaged and broken by leprosy infection.

Large bumps (legions) on the skin that do not heel and cannot feel pain.Nerve

Leprosy infection

Singh and symptom Mycobacterium leprare multiplies very

slowly Symptoms can take as long as 20 years

to appear Development of disease take from

months to years (1 year to 7 years)

Sensory Loss Paralysis

Outcomes of Nerve Damage

Transmission

• Nasal/oral Droplets Dermal Inoculations

The transmission of leprosy is thought to occur through the respiratory track.

Risk group: children, people living in endemic areas, in poor conditions, with insufficient diet, or have a disease that compromises their immunity (i.e HIV).

DIAGNOSIS

Is clinical, by finding signs of leprosy and supported with the use of acid-fast bacilli smear or skin biopsy.

But this is contingent on experienced histopathologist. What doctors typically look for include: anaesthesia of skin lesions,

and peripheral nerve thickening and tenderness . There is no serological test.Note: The genome has been sequenced .

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Treatment

Chemotherapy - First line drugs are rifampicin, dapsone, and clofazimine. - The WHO recommends that if a patient test positive in an

acid-fast skin smear they should be treated for multibacillary disease .

- The patients bacterial load decides length of treatment (6-24 months).

- Patients tend to improve quickly with minimal side-effects.

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- Second line drugs are ofloxacin and minocycline .- Triple –drug combinations have been used in cases

where a patient has only a single lesion.- Leprosy is combated with multidrug therapy to reduce

the chance of developing resistance.- Since in the 1960’s resistance to dapsone developed .

1941: Discovery of Dapsone

Targets dihydropteroate synthase (DHPS)

Inhibits nucleic acid synthesis

1964: Dapsone Resistance from Missense Mutations in DHPS

1960’s: Rifampicin and Clofazimine Discovered

Rifampicin (Rifampin): Inhibit RNA synthesis

Clofazimine: Anti-inflammatory

1995: WHO Distributes MDT Drugs for Free to Worldwide Patients

References1. Leprosy Today. “Leprosy: The Disease.” World Health Organization.

http://www.who.int/lep/leprosy/en/index.html (accessed February 25 2010).

2. Matsuoka, Masanori M. 2010. “Drug Resistance in Leprosy.” Japanese journal of infectious diseases 63, no. 1: 1-7. http://www.nih.go.jp.libproxy.lib.unc.edu (accessed February 25, 2010).

3. National Hansen’s Disease (Leprosy) Program. “Hansen’s Disease (Leprosy) Facts.” U.S. Department of Health and Human Services. http://www.hrsa.gov/hansens/ Accessed February 25 2010.

4. Scollard, DM, LB Adams, TP Gillis, JL Krahenbuhl , RW Truman, and DL Williams. 2006. “The continuing challenges of leprosy.” Clinical microbiology reviews 19, no. 2: 338-81. http://www.ncbi.nlm.nih.gov.libproxy.lib.unc.edu (accessed February 25, 2010).

5. Worobec, Sophie M. 2009. “Treatment of leprosy/Hansen's disease in the early 21st century.” Dermatologic therapy 22, no. 6: 518-37. http://www3.interscience.wiley.com.libproxy.lib.unc.edu (accessed February 25, 2010.

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