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Leprosy (cont.)

Leprosy Symptoms and Signs

The signs and symptoms of leprosy can vary depending on the individual's immune response to M. leprae. The WHO classification system uses clinical manifestations (the number of skin lesions and nerve involvement) as well as skin smear results to distinguish between forms of the disease. The two major WHO classifications are paucibacillary (PB) leprosy and multibacillary (MB) leprosy. However, within the WHO's simplified classification there can be a fairly wide range of patient presentations.

  • Paucibacillary leprosy
    • Two to five skin lesions with negative skin smear results at all sites
  • Paucibacillary single lesion leprosy
    • One skin lesion with negative skin smear results at all sites
  • Multibacillary leprosy
    • More than five skin lesions or positive skin smear results at any site

The Ridley-Jopling classification is another classification system that is used globally in evaluating patients in clinical studies and contains five different classifications of leprosy that further define the patient's severity of symptoms and disease progression. The five different categories, in order of increasing severity of disease, include indeterminate leprosy, tuberculoid leprosy, borderline tuberculoid leprosy, mid-borderline leprosy, borderline lepromatous leprosy, and lepromatous leprosy.

In general, the signs and symptoms of leprosy may vary with the form of the disease and include the following:

  • Flat or raised skin lesions or nodules, often less pigmented than the surrounding skin, though they may reddish or copper colored
  • Single or multiple skin lesions that are often found on cooler parts of the body such as the face, buttocks, and extremities
  • Thickening of the skin and peripheral nerves
  • Ulcerations of the skin
  • Peripheral nerve involvement leading to loss of sensation
  • Peripheral nerve involvement leading to muscle weakness (for example, clawed hand deformities, contractures, and foot drop)
  • Hoarseness
  • Testicular involvement leading to sexual dysfunction or sterility
  • Eye involvement including eye pain, eye redness, inability to close the eyelids, corneal ulcers, and blindness
  • Loss of eyebrows and eyelashes
  • Destruction of the nasal cartilage
Medically Reviewed by a Doctor on 9/19/2014
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