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Leprosy - Diagnosis

Written by Dr. Sangamithra, MBBS | Medically Reviewed by Dr. Ramya Ananthakrishnan, MD on Aug 07, 2020
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Leprosy - Diagnosis

Physical examination: The doctor should look for hypo-pigmented patches or nodular lesions and also loss of sensation in the extremities.

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Skin scrapings: Samples from the skin are obtained from the edge of the lesion, which is smeared on the slide and stained with Ziel-Neelsen technique. This is very helpful in demonstrating the bacilli in the skin scrapings.

Biopsy: Biopsy of the nodular lesions, thickened nerves and lymph node puncture is useful in demonstrating the presence of the bacilli.

Lepromin skin test: It is a skin test not to diagnose leprosy but to efficiently measure the Cell Mediated Immunity (CMI) of the person. The person is injected with the antigen (lepromin A). The early reaction consists of erythema and induration, which remains for 3-5 days and is not of much significance. The late reaction commences after 1-2 weeks and reaches a peak in 4 weeks time. It consists of indurated skin nodule, which later ulcerates. It distinguishes between people who can mount a CMI response against the bacilli with those who are not capable of eliciting a response.

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It is positive in case of Tuberculoid type and negative in Lepromatous Leprosy.

Antibody detection: Detection of antibody against M.leprae antigen is a very useful and specific diagnostic test.

Mouse footpad inoculation test: It is a very sensitive test for the detection of leprae bacilli in the tissue but it is unsuitable for routine diagnosis. Hence it is used only for drug resistance testing and research studies.

Advanced Molecular Testing: Polymerase chain reaction (PCR)-based methods have been useful in confirming the diagnosis in paucibacillary leprosy where few bacilli are present. It is also accurate in the detection of rifampicin/dapsone resistant strains.

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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Comments

sureshbbau768

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....

shahnikunj

its avery informative article thank you

gayani

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

innocent14

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

dearmehraj

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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