This presentation provides an overview of leprosy (Hansen's disease), including its causes, symptoms, diagnosis, treatment, and status in Pakistan. It is caused by the bacterium Mycobacterium leprae, which primarily affects the skin and nerves. Symptoms include disfiguring skin sores and lesions, as well as nerve damage leading to numbness and muscle weakness. Leprosy is diagnosed based on skin signs and presence of acid-fast bacilli. Treatment involves multidrug therapy regimens administered by the WHO. While leprosy rates are declining in Pakistan due to elimination programs, it remains a concern in other parts of Asia and Africa.

2. Presentation topic:
“LEPROSY”
Presented to:
Sir. KHEZER HAYAT
Presented by:
• MUSHTAQ AHMED

3. 1) LEPROSY:
INTRODUCTION:
 Leprosy is also known as Hansen's disease, after
the scientist who discovered M. leprae In 1873.
 Leprosy is an infectious disease that causes
severe, disfiguring skin sores and nerve damage in
the arms and legs.
 Today, about 180,000 people worldwide are infected
with leprosy, according to the World Health Organization,
most of them in Africa and Asia. About 200 people are
diagnosed with leprosy in the U.S. every year.

4. Cause OF Leprosy:
A slow-growing type of bacteria called Mycobacterium leprae.
Symptoms of Leprosy:
 primarily affects the skin and the nerves outside the brain and spinal cord.
 also affect the eyes and the thin tissue lining inside of the nose
The main symptom of leprosy :
 Disfiguring skin sores, lumps, or bumps that do not go away after several weeks. The
skin sores are pale-colored.
Nerve damage can lead to:
 Loss of feeling in the arms and legs and Muscle weakness.
MODE OF TRANSMISSION: (ACCORDING TO CDC)
 Although the mode of transmission of Hansen's disease remains uncertain, most investigators
think that M. leprae is usually spread from person to person in respiratory droplets.
Inhalation:

A large number of bacilli are discharged by infectious patient while talking, coughing and
sneezing. These bacilli enter healthy person through respiratory tract.

5. • INCUBATION PERIOD: (3 - 5) years.
• TYPES of Leprosy:
1) Tuberculoid:(paucibacillary leprosy)
 A mild, less severe form of leprosy.
 few patches of flat, pale-colored skin.
 The affected area of skin may feel numb because of nerve damage.
 Tuberculoid leprosy is less contagious than other forms.

6. 2)Lepromatous: (multibacillary leprosy)
A more severe form of the disease.
 widespread skin bumps and rashes.
numbness, and muscle weakness.
 The nose, kidneys, and male reproductive
organs may also be affected.
It is more contagious than tuberculoid leprosy.
3) Borderline. This type of leprosy have
symptoms of both the tuberculoid and
lepromatous forms

7. Diagnosis of leprosy
• 3 cardinal signs for Diagnosis of Leprosy:
one or more hypopigmented, anaesthetic skin
patches.
one or more thickened peripheral nerves;
Presence of acid–fast bacilli in the skin or
nasal smear.

8. Lepromin skin test:
The lepromin skin test is used to determine what type of
leprosy a person has.
How the Test is Performed:
 A sample of inactivated (unable to cause infection)
leprosy-causing bacteria is injected just under the skin,
usually on the forearm.
 The lump indicates that the antigen has been injected
at the correct depth.
 The injection site is labeled and examined for 3 days,
later to see if there is a reaction.
 Patients with lepromatous leprosy will not have a
positive skin reaction.

9. WHO Recommended treatment
regimen.
• 6 month regimen for Paucibacillary (PB)
Leprosy:
ADULTS:
CHILDRENS: (10-14)Y
CHILDREN (<10 Y)
Dapsone
100 mg daily single dose.
50 mg daily single dose.
25 mg daily single dose.
Rifampicin
600 mg given once a
month.
450 mg given once a
month.
300 mg given once a
month.

10. 12 month regimen for Multibacillary (MB) Leprosy
AGE DAPSONE RIFAMPICIN CLOFAZIMINE
ADULTS:
CHILDREN(10-14)Y
CHILDREN(<10) Y
100 mg daily single
dose.
50 mg daily single
dose.
25 mg daily single
dose.
600 mg once in a
month
45O mg once in a
month
300 mg daily single
dose.
50 mg daily
50 mg given every
other day
50 mg given twice
in a week

11. Single Lesion Paucibacillary (SLPB) Leprosy
(one time dose of 3 medications taken together)
AGE RIFAMPICIN OFLOXACINE MINOCYCLINE
ADULTS:
CHILDREN(5-14)Y
600 mg
300 mg
400 mg
200 mg
100 mg
50 mg

12. Vaccine for Leprosy
 Various countries around the world, namely India
and Brazil, currently use the Bacillus Calmette
Guerin (BCG) vaccine for tuberculosis to double as
a leprosy vaccine, as the two diseases are caused
by similar mycobacterial agents. However, the
effectiveness of this approach is widely disputable.
 The BCG vaccine is not used in the United
States as a leprosy vaccine because of the
unproven effectiveness of the BCG vaccine as
well as the low incidence of leprosy patients in
America.

13. • Leprosy on the decline in Pakistan WHO
(December 16, 2013)
Leprosy Elimination:
 After controlling Leprosy in Pakistan in 1996, the programme has moved
on……..
The following services are included in the elimination programme:
 - Chemotherapy – all new patients on regular treatment.
 - Prevention and Treatment of Deformity.
 - Examination of Patient’s contact for early case detection and
treatment.
 - Social and Economical Rehabilitation of patients and their
families.
 - Health Education, Awareness and Community empowerment.

16. References:
 Renault CA, Ernst JD. Mycobacterium leprae. In: Mandell GL, Bennett JE,
Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed.
Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 251.
 Kumar B, Dogra S. The infectious diseases. In: Bope ET, Kellerman RD,
eds. Conn’s Current Therapy 2012. 1st ed. Philadelphia, Pa: Saunders
Elsevier; 2011:chap 3.
 Sargent SJ. Ectoparasites. In Mayhall CG (ed): Hospital Epidemiology and
Infection Control,3rd edition Edition. Baltimore: Williams & Wilkins
2004:755-757.
 www.ausgoal.gov.au/creative-commons Department for Health and
Ageing, Government of South Australia.
 MALC Headquarters:(Marie Adelaide Leprosy Centre) Mariam Manzil,
A.M. 21,Off Shahrah-e-Liaquat,P.O Box No. 8666, Saddar Karachi 74400
Pakistan.