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Classification of Leprosy and the Clinical Symptoms

Written by Dr. Sangamithra, MBBS | Medically Reviewed by Dr. Ramya Ananthakrishnan, MD on Aug 07, 2020
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Classification of Leprosy and the clinical symptoms

Leprosy is classified into several types based on the bacterial load present in the lesions, the extent of skin and nerve involvement and based on the presence of deformities. Several types of classification like Madrid classification, Ridley & Jopling classification Indian Classification, WHO classification , Field Worker's Classification etc.


Based on the 2 commonly used classifications, leprosy is classified into six types based on the clinical features (Ridley & Jopling classification):

The type of the disease is a reflection of the immune status of the host.

The first sign of the disease is the feeling of numbness or loss of sensation for temperature (heat) followed by touch and pain which usually begins at the extremities. The skin lesions appear later during the course of the disease.

Disease Clinical Features
Indeterminate leprosy They are the first type of skin lesions characterized by hypo-pigmented spots
The lesions undergo healing spontaneously
Paucibacillary (tuberculoid leprosy) A large red patch with well-defined raised borders or a large hypo pigmented asymmetrical lesion.
Lesion is dry and hairless
Infectivity is minimal at this stage
Loss of sensation is seen
Nerves become thick followed by loss of function
It either progresses to the borderline stage or spontaneously get cured
Borderline borderline leprosy Characterized by small and numerous skin lesions
The disease goes back to the tuberculoid stage or progresses to the next stage
Borderline borderline leprosy Several small, irregular red lesions are seen
Moderate sensory loss is seen
It either goes back to the previous stage or progresses to the next
Borderline lepromatous leprosy Several lesions such as plaques, macules, papules, and nodules are seen
Lesions have a characteristic inverted saucer like appearance
Multibacillary Hansenís disease (lepromatous leprosy) Early symptoms:
Several lesions such as plaques, macules, papules, and nodules are seen
Nasal congestion, discharge and bleeding is seen
Inflammation of the leg and ankles
Progressive symptoms:
Thickening of the dermis (skin) in the forehead and ear lobes
Loss of eyebrows and eyelashes
Eye defects such as glaucoma and blindness are seen
Nodules in the legs break and form ulcers
Enlargement of the breast and sterility occurs in the males
Internal infection results in the enlargement of the liver and lymph nodes
Loss of sensation in the peripheral nerves. Deformation of the fingers and toes results due to painless repeated trauma

The Indian classification has an additional type, the neuritic type, which is bacteriologically negative and shows neural involvement without any skin lesions.

Leprosy - References

  1. Leprosy elimination - (http://www.who.int/lep/)
  2. Leprosy - (http://www.nlm.nih.gov/medlineplus/ency/article/001347.htm)

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hi this is sureshbabu.i have effected with hanseen disease,and i used MDT for one and half year,and doctors told to stop me and do some exercise..now main problem is one of my right hand fingers are clawed and it is shivering,and my skin turn into black on my face....tell me it is dangerous disease..how could i solve it i am doing small exercises but my fingers are same..please tell me and please helping to me...and my thinking too much on this unable to concentrate on anyhing...can i go to physiotheraphy...will the fingers come into normal...or can i go GYM and do exercises please please please help me....


its avery informative article thank you


Is it dangerous in any way to make a patient who is undergoing treatment take up writing exercises as physiotherapy to get the fingers working again?The fingers are clawed in the right hand and the patient has been asked o come in for physiotherapy sessions as well


Thanks a lot for providing qualitative & updated news about leprosy.Really this website has enhanced my leprosy knowledge.


i am a medical student requires a detail study of leprosy for seminar & i found your website very informative. Thank you, best regards.

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