1. LEPROSY
Gargaritano. Gindap. Glomo.

2. Leprosy:
Also known as HANSEN’S DISEASE
Caused by: Mycobacterium leprae
Slowly progressive infection
Mainly affecting the skin and peripheral nerves→ disabling deformities
M. leprae is an acid fast obligate intracellular organism
Poorly growing
Proliferates best at 32°C-34°C
Secretes no toxins
Virulence is based on properties of its cell wall

3. Pathogenesis
Transmission:
Person to
person through
aerosols from
asymptomatic
lesions
Mycobacteria leprae
Enter through respiratory tract
Schwann cells in cooler places
(cutaneous nerves and peripheral trunks of limbs and face)
Bacilli multiplies in the schwann cells
Good CMI response Weak CMI response
1. No skin or nerve
appear, or
2. Skin / nerve lesions
appears followed by
spontaneous healing ,
or
3. Pauci-bacillary leprosy
In addition to skin and
nerve, eyes, testes,
kidneys, voluntary /
smooth muscles, reticulial
endothelial system and
vascular endothelial get
involved
Disabilities of deformities

4. Pathogenesis
• Two extreme type of immune response : two polar forms :
Tuberculoid at one end
Lepromatous at the other
• Persons with good CMI response develops milder and localized form
of disease with less bacteria load
• Whereas, persons with weak or absent CMI develop disseminated
wide spread disease with high bacterial load
Tuberculoid : paucibacillary leprosy
Lepromatous: multibacillary leprosy

5. Paucibacillary : Multibacillary:
Gross changes:
Localized
Asymmetrical involvement of large peripheral nerve
Macule (flat)/ papule (slightly raised)
Plaque
Erythematous (red)
Irregular shapes with indurated, elevated ,
hyperpigmented margins
Histologic changes:
Granulomatous
Bacilli are almost never found
→
Reflects strong T cell immunity
Th 1 response in association with IL-2 and IFN-y
Gross changes:
Widespread
Lesion maybe- multiple or innumerable
Bilaterally Symmetrical
Progress to the formation of plaques and nodules=
distinct LEONINE facies
Hypoesthetic and anesthethis lesions
Histological changes:
Red snapper:
Acid fast bacilli within macrophages
Lesions contains large aggregates of lipid-laden
macrophages (lepra cells) filled with masses (globi) of
acid fast bacilli
→
Reflects poor Th 1 response
Certain changes ….

6. • Multibacillary lesions:
- Also known as anergic leprosy : unresponsive
- may lead to loss of sensation and trophic changes in the hands and
feet
• The lymph nodes would contain aggregates of bacteria –filled foamy
macrophages

7. Involvement of the nerves
Stage 1
INVOLVEMENT
Stage 2
DAMAGE
Stage 3
DESTRUCTION
 Thickening of nerve
 Tenderness
 Pain
 No loss of function
No functional
impairment
 Long-standing
paralysis
Recovery of nerve
function not possible
 Incomplete paralysis
 Recent complete
paralysis
Functional impairment
present, but recovery is
possible

8. Keywords :
Leprosy Hansen’s disease
Slowly progressive infection
By Mycobacterium leprae
Affecting skin, peripheral nerves causing disabling
deformities
Lepra cells Large aggregates of lipid-laden macrophages seen in
multibacillary lesion
Leonine facies Charactristic of multibaci. leprosy where infiltrative
lesions appear on cheeks, earlobes, frontal and
maxillary eminence
Skin is thickened due to infiltrations and nodulations
Eyebrows thin and completely lost
Tuberculoid lesion Paucibacillary lesion
Lepromatous lesion Multibacillary lesion

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