Chapter 159 :: Leprosy Flashcards
most important epidemiologic indicators of leprosy burden
new case detection rate by country, and the proportion of cases in children, those with multibacillary disease and those with grade 2 disability, indicating a late diagnosis
Ridley and Jopling
clinical, histopathologic, and immunologic criteria
well-defined plaques, usually a few in just one segment of the body, hypochromic and/or erythematous, sometimes atrophic, present with papules or tubercles that are mainly circinate on the periphery of the lesions
better cellmediated immunity
polar tuberculoid leprosy
classical foveolar lesions
borderline-borderline
positive acid-fast bacilli result on slit-skin smear eliminates primary neural leprosy
an immunologic Type III hypersensitivity response, occurs with immune complex deposition
erythema nodosum leprosum (ENL)
Type IV hypersensitivity immune response, is caused by a specific increase in cell-mediated immunity against M. leprae
Type 1 reaction or reversal reaction
no acid-fast bacilli detected in tuberculoid leprosy lesions
0
Reactions never occur in Indeterminate patients. Up to 50% of all patients on multidrug therapy may present reactions during treatment, but these reactions can also occur before and after therapy
Reversal reaction can occur in up to 30% of patients, whereas tuberculoid leprosy cases are seldom affected, 127 the majority of the reactional episodes occur in borderline forms, mainly borderlinelepromatous and borderline-borderline, followed by lepromatous leprosy
A true relapse must be defined after confirmation of completion of the first treatment by the patient.
affinity to fat tissue and macrophage deposits leading to skin hyperpigmentation, especially in the lesions
Clofazimine
A household contact has a 5- to 8-fold higher risk of contracting leprosy than a person without contact with a case
