Leprosy Symptoms, Treatments, History, and Causes

Written by Kelli Miller

• What Is Leprosy?
• Leprosy Symptoms
• What Causes Leprosy?
• Forms of Leprosy
• Leprosy Diagnosis
• Leprosy Treatment
• Leprosy Complications
• More

Leprosy is an infectious disease that causes severe, disfiguring skin sores and nerve damage in the arms, legs, and skin areas around your body. Leprosy has been around since ancient times. Outbreaks have affected people on every continent.

But leprosy isn’t that contagious. You can catch it only if you come into close and repeated contact with nose and mouth droplets from someone with untreated leprosy. Children are more likely to get leprosy than adults.

Today, about 208,000 people worldwide are infected with leprosy, according to the World Health Organization, most of them in Africa and Asia. About 100 people are diagnosed with leprosy in the U.S. every year, mostly in the South, California, Hawaii, and some U. S. territories.

Leprosy primarily affects your skin and nerves outside your brain and spinal cord, called the peripheral nerves. It may also strike your eyes and the thin tissue lining the inside of your nose.

The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that don’t go away after several weeks or months. The skin sores are pale-colored.

Nerve damage can lead to:

• Loss of feeling in the arms and legs
• Muscle weakness

It usually takes about 3 to 5 years for symptoms to appear after coming into contact with the bacteria that causes leprosy. Some people do not develop symptoms until 20 years later. The time between contact with the bacteria and the appearance of symptoms is called the incubation period. Leprosy’s long incubation period makes it very difficult for doctors to determine when and where a person with leprosy got infected.

Leprosy is caused by a slow-growing type of bacteria called Mycobacterium leprae (M. leprae). Leprosy is also known as Hansen’s disease, after the scientist who discovered M. leprae in 1873.

It isn’t clear exactly how leprosy is transmitted. When a person with leprosy coughs or sneezes, they may spread droplets containing the M. leprae bacteria that another person breathes in. Close physical contact with an infected person is necessary to transmit leprosy. It isn’t spread by casual contact with an infected person, like shaking hands, hugging, or sitting next to them on a bus or at a table during a meal.

Pregnant mothers with leprosy can’t pass it to their unborn babies. It’s not transmitted by sexual contact either.

Leprosy is defined by the number and type of skin sores you have. Specific symptoms and treatment depend on the type of leprosy. The types are:

• Tuberculoid. A mild, less severe form of leprosy. People with this type have only one or a few patches of flat, pale-colored skin (paucibacillary leprosy). The affected area of skin may feel numb because of nerve damage underneath. Tuberculoid leprosy is less contagious than other forms.
• Lepromatous. A more severe form of the disease. It brings widespread skin bumps and rashes (multibacillary leprosy), numbness, and muscle weakness. The nose, kidneys, and male reproductive organs may also be affected. It is more contagious than tuberculoid leprosy.
• Borderline. People with this type of leprosy have symptoms of both the tuberculoid and lepromatous forms.

You may also hear doctors use this simpler classification:

• Single lesion paucibacillary (SLPB): One lesion
• Paucibacillary (PB): Two to five lesions
• Multibacillary (MB): Six or more lesions

If you have a skin sore that might be leprosy, the doctor will remove a small sample of it and send it to a lab to be examined. This is called a skin biopsy. Your doctor may also do a skin smear test. If you have paucibacillary leprosy, there won’t be any bacteria in the test results. If you have multibacillary leprosy, there will be.

You may need a lepromin skin test to see which type of leprosy you have. For this test, the doctor will inject a small amount of inactive leprosy-causing bacteria just underneath the skin of your forearm. They’ll check the spot where you got the shot 3 days later, and then again 28 days later, to see if you have a reaction. If you do have a reaction, you may have tuberculoid or borderline tuberculoid leprosy. People who don’t have leprosy or who have lepromatous leprosy won’t have a reaction to this test.

Leprosy can be cured. In the last 2 decades, 16 million people with leprosy have been cured. The World Health Organization provides free treatment for all people with leprosy.

Treatment depends on the type of leprosy that you have. Antibiotics are used to treat the infection. Doctors recommend long-term treatment, usually for 6 months to a year. If you have severe leprosy, you may need to take antibiotics longer. Antibiotics can’t treat the nerve damage that comes with leprosy.

Multidrug therapy (MDT) is a common treatment for leprosy that combines antibiotics. That means you’ll take two or more medications, often antibiotics:

• Paucibacillary leprosy: You’ll take two antibiotics, such as dapsone each day and rifampicin once a month.
• Multibacillary leprosy: You’ll take a daily dose of the antibiotic clofazimine in addition to the daily dapsone and monthly rifampicin. You’ll take multidrug therapy for 1-2 years, and then you’ll be cured.

You may also take anti-inflammatory drugs to control nerve pain and damage related to leprosy. This could include steroids, like prednisone.

Doctors sometimes treat leprosy with thalidomide, a potent medication that suppresses your immune system. It helps treat leprosy skin nodules. Thalidomide is also known to cause severe, life-threatening birth defects. Never take it if you’re pregnant or plan to become pregnant.

Without treatment, leprosy can permanently damage your skin, nerves, arms, legs, feet, and eyes.

Complications of leprosy can include:

• Blindness or glaucoma
• Iritis
• Hair loss
• Infertility
• Disfiguration of the face (including permanent swelling, bumps, and lumps)
• Erectile dysfunction and infertility in men
• Kidney failure
• Muscle weakness that leads to claw-like hands or a not being able to flex your feet
• Permanent damage to the inside of your nose, which can lead to nosebleeds and a chronic stuffy nose
• Permanent damage to the nerves outside your brain and spinal cord, including those in the arms, legs, and feet

Nerve damage can lead to a dangerous loss of feeling. If you have leprosy-related nerve damage, you may not feel pain when you get cuts, burns, or other injuries on your hands, legs, or feet.

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Leprosy Symptoms, Treatments, History, and Causes

Written by Kelli Miller

• What Is Leprosy?
• Leprosy Symptoms
• What Causes Leprosy?
• Forms of Leprosy
• Leprosy Diagnosis
• Leprosy Treatment
• Leprosy Complications
• More

Leprosy is an infectious disease that causes severe, disfiguring skin sores and nerve damage in the arms, legs, and skin areas around your body. Leprosy has been around since ancient times. Outbreaks have affected people on every continent.

But leprosy isn’t that contagious. You can catch it only if you come into close and repeated contact with nose and mouth droplets from someone with untreated leprosy. Children are more likely to get leprosy than adults.

Today, about 208,000 people worldwide are infected with leprosy, according to the World Health Organization, most of them in Africa and Asia. About 100 people are diagnosed with leprosy in the U.S. every year, mostly in the South, California, Hawaii, and some U.S. territories.

Leprosy primarily affects your skin and nerves outside your brain and spinal cord, called the peripheral nerves. It may also strike your eyes and the thin tissue lining the inside of your nose.

The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that don’t go away after several weeks or months. The skin sores are pale-colored.

Nerve damage can lead to:

• Loss of feeling in the arms and legs
• Muscle weakness

It usually takes about 3 to 5 years for symptoms to appear after coming into contact with the bacteria that causes leprosy. Some people do not develop symptoms until 20 years later. The time between contact with the bacteria and the appearance of symptoms is called the incubation period. Leprosy’s long incubation period makes it very difficult for doctors to determine when and where a person with leprosy got infected.

Leprosy is caused by a slow-growing type of bacteria called Mycobacterium leprae (M. leprae). Leprosy is also known as Hansen’s disease, after the scientist who discovered M. leprae in 1873.

It isn’t clear exactly how leprosy is transmitted. When a person with leprosy coughs or sneezes, they may spread droplets containing the M. leprae bacteria that another person breathes in. Close physical contact with an infected person is necessary to transmit leprosy. It isn’t spread by casual contact with an infected person, like shaking hands, hugging, or sitting next to them on a bus or at a table during a meal.

Pregnant mothers with leprosy can’t pass it to their unborn babies. It’s not transmitted by sexual contact either.

Leprosy is defined by the number and type of skin sores you have. Specific symptoms and treatment depend on the type of leprosy. The types are:

• Tuberculoid. A mild, less severe form of leprosy. People with this type have only one or a few patches of flat, pale-colored skin (paucibacillary leprosy). The affected area of skin may feel numb because of nerve damage underneath. Tuberculoid leprosy is less contagious than other forms.
• Lepromatous. A more severe form of the disease. It brings widespread skin bumps and rashes (multibacillary leprosy), numbness, and muscle weakness. The nose, kidneys, and male reproductive organs may also be affected. It is more contagious than tuberculoid leprosy.
• Borderline. People with this type of leprosy have symptoms of both the tuberculoid and lepromatous forms.

You may also hear doctors use this simpler classification:

• Single lesion paucibacillary (SLPB): One lesion
• Paucibacillary (PB): Two to five lesions
• Multibacillary (MB): Six or more lesions

If you have a skin sore that might be leprosy, the doctor will remove a small sample of it and send it to a lab to be examined. This is called a skin biopsy. Your doctor may also do a skin smear test. If you have paucibacillary leprosy, there won’t be any bacteria in the test results. If you have multibacillary leprosy, there will be.

You may need a lepromin skin test to see which type of leprosy you have. For this test, the doctor will inject a small amount of inactive leprosy-causing bacteria just underneath the skin of your forearm. They’ll check the spot where you got the shot 3 days later, and then again 28 days later, to see if you have a reaction. If you do have a reaction, you may have tuberculoid or borderline tuberculoid leprosy. People who don’t have leprosy or who have lepromatous leprosy won’t have a reaction to this test.

Leprosy can be cured. In the last 2 decades, 16 million people with leprosy have been cured. The World Health Organization provides free treatment for all people with leprosy.

Treatment depends on the type of leprosy that you have. Antibiotics are used to treat the infection. Doctors recommend long-term treatment, usually for 6 months to a year. If you have severe leprosy, you may need to take antibiotics longer. Antibiotics can’t treat the nerve damage that comes with leprosy.

Multidrug therapy (MDT) is a common treatment for leprosy that combines antibiotics. That means you’ll take two or more medications, often antibiotics:

• Paucibacillary leprosy: You’ll take two antibiotics, such as dapsone each day and rifampicin once a month.
• Multibacillary leprosy: You’ll take a daily dose of the antibiotic clofazimine in addition to the daily dapsone and monthly rifampicin. You’ll take multidrug therapy for 1-2 years, and then you’ll be cured.

You may also take anti-inflammatory drugs to control nerve pain and damage related to leprosy. This could include steroids, like prednisone.

Doctors sometimes treat leprosy with thalidomide, a potent medication that suppresses your immune system. It helps treat leprosy skin nodules. Thalidomide is also known to cause severe, life-threatening birth defects. Never take it if you’re pregnant or plan to become pregnant.

Without treatment, leprosy can permanently damage your skin, nerves, arms, legs, feet, and eyes.

Complications of leprosy can include:

• Blindness or glaucoma
• Iritis
• Hair loss
• Infertility
• Disfiguration of the face (including permanent swelling, bumps, and lumps)
• Erectile dysfunction and infertility in men
• Kidney failure
• Muscle weakness that leads to claw-like hands or a not being able to flex your feet
• Permanent damage to the inside of your nose, which can lead to nosebleeds and a chronic stuffy nose
• Permanent damage to the nerves outside your brain and spinal cord, including those in the arms, legs, and feet

Nerve damage can lead to a dangerous loss of feeling. If you have leprosy-related nerve damage, you may not feel pain when you get cuts, burns, or other injuries on your hands, legs, or feet.

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Leprosy bacteria restore and “rejuvenate” liver cells

Science
November 16, 2022

Further

Alexander
Sheremetiev

news editor

Alexander
Sheremetiev

news editor

The forgotten disease bacteria can reprogram liver cells back to their original state.

Read Hi-Tech at

Researchers have found that leprosy bacteria can reprogram cells to increase liver size in adult animals. This process can be controlled without damaging the organ or leaving scars on it. Scientists believe that the discovery will help in creating a safe alternative to transplantation.

In their work, biologists infected 57 nine-banded armadillos (Dasypus novemcinctus) with the bacteria Mycobacterium leprae, which causes leprosy. These animals were not chosen by chance: they are natural carriers of this disease. The scientists then compared the livers of the infected armadillos with those that were not infected and those that showed resistance to the infection.

They noticed that infected animals developed enlarged, healthy livers. Moreover, all vital components, such as blood vessels, bile ducts and lobules, looked the same as in uninfected and resistant animals. In addition, the researchers found the presence of hepatocytes, the primary cells of the liver, inside the infected liver.

Scheme of the experiment. Image: Samuel Hess et al., Cell Reports Medicine

The researchers believe that the leprosy bacteria reprogrammed the liver cells, returning them to an earlier stage of their original, healthy cells. As a result, they became hepatocytes again and grew new liver tissues.

If we can determine how bacteria grow the liver as a functional organ without causing side effects in live animals, we can use this knowledge to develop safer therapeutic interventions to rejuvenate the aging liver and regenerate damaged tissues.

Anura Rambukkana, Professor at the Center for Regenerative Medicine at the University of Edinburgh in Scotland, co-author of the study

Leprosy is a type of granulomatosis (a chronic infectious disease) caused by the mycobacteria Mycobacterium leprae and Mycobacterium lepromatosis. It proceeds with predominant lesions of the skin, peripheral nervous system, and in some cases other organs.

Leprosy is classified as a neglected disease by WHO. These are diseases that predominantly affect the poorest sections of the population in the most backward regions of Asia, Africa and Latin America.

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Leprosy: causes, symptoms and recommendations for the treatment of the disease. Dr. Peter

Leprosy has been described in ancient scriptures. Today it is recorded mainly in India, South America and Southeast Asia. Although the number of cases worldwide has decreased and leprosy can be treated with antibiotics, severe cases still occur. Victims often become outcasts and are forced to be treated in closed institutions due to skin changes caused by leprosy. Early treatment is important to prevent disability associated with leprosy. If left untreated, the disease can lead to severe physical disabilities and severe damage to the skin, eyes, and nerves.

Causes

Worldwide, the annual number of new cases of leprosy for many years is less than 300,000. The main distribution areas include countries in Southeast Asia, some countries in Africa and South America (especially Brazil). Leprosy—or leprosy—is caused by the bacterium Mycobacterium leprae, which can live inside human cells. The disease is transmitted from person to person. However, it is not known exactly how leprosy develops. Some people are carriers of the pathogen without developing the disease.

Only about every 20th person infected with the bacteria develops the disease: months or years after infection, they develop the first symptoms in the form of altered individual small areas of the skin, which may again disappear on their own.

When the leprosy pathogen is activated, various clinical symptoms can develop depending on the individual immune response:

• Lepromatous leprosy (or multibacillary) is the most severe form of the disease and occurs when the immune system does not react to the pathogen at all – the absence of an immune response. Lepromatous leprosy is highly contagious.

• Tuberculoid leprosy (or small bacillary) occurs when the body has an active immune system and the disease is milder than the lepromatous form. The risk of contracting this form of the disease is low. All forms of leprosy that lie between the two extreme forms are called borderline leprosy.

Since the pathogen affects the nerve cells of patients, leprosy primarily affects the sense of touch. As a result, victims often burn and damage their hands and feet. Therefore, severe mutilation and disability are typical for leprosy. In the further course of the disease, it can also lead to blindness.

Symptoms of leprosy

Leprosy is primarily transmitted from person to person, but how the infection works is not fully understood. The causative agent is probably transmitted with nasal secretions by airborne droplets. Favorable factors for infection are: poor nutrition, dirty water, cramped living quarters.

The causative agent of leprosy is slightly contagious. Thus, prolonged close physical contact with people with leprosy, such as those living in a shared home, is considered a prerequisite for infection. In countries where leprosy is still widespread, the disease is usually transmitted during childhood. Whether a disease manifests itself or not depends to a large extent on the body’s own immune system. In addition, a predisposition to leprosy may also have partially hereditary causes. Only about one in 20 people is affected by the disease.

The incubation period is highly variable, ranging from 9 months to 20 years before the first symptoms of leprosy appear. On average, two to four years. The reason for the long incubation period is the slow growth rate of the pathogen: the bacterial species Mycobacterium leprae divides only every 13 days. This is extremely slow compared to other bacteria.

The symptoms of leprosy can vary greatly. The disease most often and most severely manifests itself on the face – sometimes the eyes, limbs and skin are also affected. The first signs of leprosy are often numbness in the fingers or feet and swelling of the nerve fibers.

Other early symptoms of the disease include lesions on areas of the skin that are red or pale in color compared to the rest of the body. These areas do not feel pain and touch, become numb. Sometimes those affected mistake the skin changes associated with leprosy for other diseases, such as psoriasis or parasitosis, a fungus.

The clinical presentation of leprosy depends on the individual’s immune response to the infection. After skin changes, various forms of leprosy can develop depending on the response of the immune system.

Lepromatous leprosy

After the onset of the disease, if the immune system does not respond, initially mild symptoms may progress to the most severe form of leprosy, which is highly contagious and can be fatal if left untreated. The typical symptoms of lepromatous leprosy arise from the fact that the causative bacteria (Mycobacterium leprae) multiply almost unhindered in tissues: Up to a billion bacteria can be found per gram of tissue (hence the name “multibacillary leprosy”). The symptoms are initially reddened skin changes, especially on the face, which later develop into nodular lepromas.

In addition, nerve cells often die, which entails a considerable risk of injury to the victims: scars and mutilations are common consequences. In addition, lepromatous leprosy can lead to eyebrow loss. In the later stages, the infection often also affects the internal organs and bones. Other symptoms of this severe form are muscle atrophy and associated signs of paralysis.

Tuberculoid leprosy

In the presence of an immune response, the first symptoms may also progress to another extreme form of the disease: the so-called tuberculoid leprosy. This milder form of leprosy is manifested by local skin symptoms: patchy discoloration of the skin occurs. In addition, due to nerve damage at an early stage, partial paralysis occurs. Typically, the body’s own immune system slows down the proliferation of bacteria, resulting in significantly less pathogen in the tissue (hence the name “small-bacillary leprosy”).

Possible complications and risks

If leprosy is detected early enough, the prognosis is good. However, a complete cure usually requires long-term antibiotic treatment. This can lead to complications in the form of side effects and interactions with other drugs. In addition, during treatment, severe skin reactions may develop, which are reactions of the immune system to antibiotics. If left untreated, leprosy takes a chronic course: the disease of the skin, mucous membranes and affected nerve cells progresses slowly but steadily and often leads to severe disability.

Diagnosis

Leprosy can only be accurately diagnosed if the pathogen is identified. In addition, there is the possibility of histological examination of tissue samples (for example, skin) for the presence of changes. The first presumptive diagnosis may be based on the typical symptoms of leprosy, such as numbness and persistent skin changes (colorless spots). The most important measure for diagnosing leprosy is the identification of the DNA of the causative agent (for example, using PCR). In addition, the causative agent of the disease itself can be identified as a rod-shaped bacterium in a skin smear, for example, under a microscope using a specific staining method (the so-called Ziehl-Neelsen stain).

How to treat leprosy

Mycobacteria are destroyed by combination therapy with the selection of antibiotics – rifampicin, clofazimine, dapsone. Which combination is best for the treatment of leprosy in each case depends on the form of the disease. While tuberculoid leprosy is usually treated with a combination of dapsone and rifampicin for six to nine months, for severe pathology, a combination of all three active ingredients is used for one to one and a half years.

After the first course of antibiotic treatment, people with leprosy are no longer contagious. Only in exceptional cases, for example, with individual skin changes, drug treatment of leprosy can be limited to one drug. In these cases, the active ingredients ofloxacin and minocycline are used in addition to dapsone.