Introduction to Leprosy

Leprosy, also known as leprosy, is one of the bacterial infectious diseases. It is highly contagious and often fatal if left untreated. Today, however, leprosy can be cured through early detection and treatment with antibiotics. In Germany, leprosy occurs only very rarely due to very good hygienic conditions. In tropical countries like India, however, leprosy sufferers are more common.

What is leprosy?

Typical symptoms of lepromatous leprosy are bacterially infected nodules caused by lepromas in the skin. This then leads to the well-known mutilations and scars or complete loss of individual body parts. See AbbreviationFinder for abbreviations related to Leprosy.

Leprosy is known as the disease of the poor because of its global geographic distribution. Due to the habitat of the disease carriers, it can mainly be observed in warm climate zones.

Basically, leprosy is an infectious disease. It can therefore be transmitted by contagion and can be treated causally and symptomatically well with today’s modern medical methods.

Since leprosy can affect many people at the same time and leprosy affects about 12 million patients worldwide, the disease belongs to the epidemic category. The disease is limited to certain areas of human skin. The causative agents of leprosy trigger the typical symptoms primarily on the nerve tracts and nerve endings, the mucous membranes and the skin of humans.

Causes

The cause of leprosy lies in a disease-causing pathogen, which in bacteriology is called the bacterium Mycobacterium leprae. This pathogen is related to the tubercle bacterium, the causative agent of tuberculosis. People become infected through constant contact with people who are already ill. It is assumed that a weakening of the immune system due to poor nutrition, inadequate hygienic conditions and limited existential supplies makes the organism susceptible to the outbreak of the disease.

The nasal secretions and purulent skin irritations excreted by infected patients contain massive amounts of leprosy bacteria. The contact is enormously contagious for this reason. Open wounds on the surface of the skin and the ingestion of droplets through the respiratory tract allow almost unlimited transmission of the causative agent of leprosy.

Symptoms, Ailments & Signs

The symptoms and signs of leprosy are very different and varied. The most visible are of course the symptoms around the face. One of the first symptoms is characterized by numbness in the sense of tactile sensory disturbances. In the further course, typical skin spots appear, which can appear darker or lighter depending on the skin type.

Typical symptoms of lepromatous leprosy are bacterially infected nodules caused by lepromas in the skin. This then leads to the well-known mutilations and scars or complete loss of individual body parts. In later stages, the disease can also affect internal organs, leaving the affected person crippled if left untreated. These are often accompanied by signs of paralysis.

In tuberculous leprosy, the symptoms and signs of the disease tend to be localized. Discoloration of the skin often occurs in the form of spots. Here, too, paralysis occurs later on. Unlike lepromatous leprosy, this form can heal on its own.

Course of the disease

The course of the disease of leprosy is differentiated between the tuberculoid and the lepromatous form. The disease, which has become so terrifying due to the mutilations, shows this characteristic picture exclusively in the tuberculoid form. Due to the impairment of the nerve tracts, those affected have no sense of touch in their fingertips. In addition, the terminal limbs are no longer sufficiently supplied with blood. Due to the insensitivity to pain, numerous injuries occur on the limbs, which lead to the symptoms of mutilation.

In contrast to tubercoloid leprosy, the lepromatous course of the disease is much more serious. The skin and mucous membranes show massive symptoms of the disease. Knot-like hardening occurs and the extremities are partially paralyzed due to the impairment of nerve function. As the leprosy progresses, the nodular growths appear on the face, back, hands and feet. The patients suffer from reduced perspiration, intermittent high fever and lose weight rapidly. Hair loss is also a consequence of the disease of the skin and nerve supply systems.

Complications

Whether there are complications with leprosy depends on the form of the disease and the time at which therapy begins. While tuberculoid leprosy has a rather mild course of the disease and usually heals on its own, lepromatous leprosy, which is considered the most severe form of leprosy, can even be fatal.

Without appropriate treatment, there is a risk of serious consequences of leprosy. Complications often affect the patient’s eyes. For example, madarosis (loss of eyelashes and eyebrows) can occur, but this has no effect on eyesight.

However, this is endangered by other effects such as iritis, iris atrophy or facial paralysis. There is also a risk of hair loss. Muscle weakness is also possible. Among the most severe effects of leprosy are disfigurement and mutilation, which are secondary changes.

They are the result of the destruction of sensory fibers, which leads to a sensory disorder. As a result, the patient no longer has any sense of touch. He cannot feel cold, heat or pain. Sometimes there is complete anesthesia. Rhagades are also formed, which pose a high risk of secondary infections. Even minor injuries can result in abscesses and necrosis. As the disease progresses, the necrotic fingers or toes may fall off.

When should you go to the doctor?

If numbness or the characteristic lumps under the skin are noticed, a doctor’s visit is recommended. Leprosy is a serious condition that, if left untreated, can lead to the loss of fingers and toes. People who have a concrete suspicion should therefore definitely seek medical advice. If mutilation or scarring should develop, seek immediate medical attention. The relatives must closely monitor the person concerned and call the emergency doctor or the medical emergency service if there are serious signs of illness.

Since leprosy occurs only very rarely nowadays, the symptoms should first be clarified. People who suffer from tuberculosis often develop leprosy as well and should therefore consult a doctor closely. The loss of eyelashes and eyebrows indicates advanced leprosy that needs immediate treatment. Affected people should consult their family doctor or an internist. Other contacts are the hepatologist or the gastroenterologist, depending on the symptoms and triggers of the disease.

Treatment & Therapy

The basic medical therapy to combat leprosy is the use of high-dose and effective drugs. These are not administered individually, but mostly in combination to increase the therapeutic effectiveness. Physicians almost exclusively use antibiotics. These are intended to stop or reduce the division and thus the multiplication of the pathogens. In order to treat tuberculoid leprosy, it is necessary for the therapy to last at least six months.

For the more aggressive and severe form, the therapy must be continued for two years in order to achieve healing success. So-called reserve leprostatics are offered by the pharmaceutical industry so that the treatment can be continued in the event of insufficient healing. The treatment of leprosy also includes the care of the wounds and active movement treatment in order to minimize and stop any signs of paralysis at an early stage.

Outlook & Forecast

The occurrence of the disease leprosy is directly linked to poor living conditions. At present, the infectious disease occurs mainly in South America, South Asia and India. The World Health Organization has achieved the goal of almost eradicating new cases by the year 2000. In industrialized countries, contracting leprosy is almost impossible. A strong immune system makes infection comparatively unlikely.

After an illness, the prognosis depends on the type of leprosy and the time of diagnosis. Tuberculoid leprosy, for the most part, heals on its own; without medical treatment, the lepromatous form leads to death. Early diagnosis is usually accompanied by a favorable outlook. However, patients have to put up with long-term treatment, which is sometimes associated with side effects. So defensive reactions of the body are not uncommon. If those affected begin treatment only after mutilation and paralysis have already set in, these can no longer be reversed.

If leprosy does not heal on its own without medical attention, it will continue to progress. The skin and nerves are permanently damaged. Disabilities leading to a life of dependency are common.

Aftercare

Since leprosy shows different characteristics, both the course of the disease and the aftercare can vary in intensity. This usually focuses in the form of prevention on curbing the symptoms for as long as possible. Without medical treatment, those affected suffer considerable consequential damage. Usually there are complaints in the eyes, which lead to complications. The everyday life of those affected is difficult to cope with on their own, which is why the help of relatives is indispensable.

In addition, those affected should be careful to be as careful as possible with their actions in order to reduce their risk of injury. Even the smallest injury can promote the development of an abscess. Those affected should see a doctor regularly to check the medication and possible side effects. Psychological support for relatives can also be recommended.

You can do that yourself

If leprosy is suspected, a doctor must be consulted immediately. Under no circumstances should the symptoms, which initially seem harmless, be treated by yourself. Since leprosy is extremely contagious, the patient usually needs intensive care and isolation.

Most leprosy infections are counted in India and the neighboring countries of Bangladesh and Myanmar, formerly Burma, as well as in Brazil. Tourists and business travelers are not usually at risk as long as they stay in the tourist areas and business centers of major cities. However, for medical reasons, expeditions to the slums of Indian metropolises are strongly discouraged. Leprosy and a number of other diseases that have already died out in Europe are still commonplace here. When confronted with lepers, any physical contact must be avoided. Because of the risk of droplet infectionThe mere physical proximity to infected people is already dangerous. Anyone who notices symptoms such as numbness in the limbs or dark spots on the skin after such an incident must seek medical treatment immediately and point out the possibility of leprosy infection.

A weakened immune system, particularly due to malnutrition, is thought to increase susceptibility to leprosy. Measures that strengthen the immune system, in particular a healthy diet rich in vitamins, can therefore reduce the risk of infection or contribute to faster recovery.