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Classification of leprosy

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Classification of leprosy

  1. 1. SKIN & VD 4-2-2013 CLASSIFICATION OF LEPROSYI. RIDLEY AND JOPLING’S CLINICAL CLASSIFICATION OF LEPROSYTUBERCULOID LEPROSY (TT)  Bacteria invade Schwann cells. Granuloma is formed due to good immune response. Since myelin sheath is tough and cannot expand, nerve is compressed.  Nerve compression leads to loss of hair, loss of sweating and anaesthesia  Presence of granuloma in biopsy.  Smear is negative for bacilli  Lepromin test highly positiveBORDERLINE TUBERCULOID (BT)  Borders ill defined  Satellite lesions (1 to 10) around the main lesions.  Smear is negative, lepromin test positive.LEPROMATOUS LEPROSY (LL)  No immunity: lepromin test negative, smear is laden with macrophages filled with lepra bacilli. (Grenzone)  Many lesions all over the body.  Bilateral, symmetrical lesions.  Blood stream dissemination.  Hair loss, sweating loss not present as sympathetic nerves are not involved.  Well formed, symmetrical nodules.  Glove and stocking pattern of anaesthesia (fibrosis of lesions containing bacilli laden macrophages)BORDERLINE BORDERLINE (BB)  Annular or punched out lesions  Features can be of either end of the disease  Smear is positive, lepromin negative.BORDERLINE LEPROMATOUS (BL)  Not so symmetrical as in LL.  Smear negative in areas other than lesions.  Grenzone is not well determined. Keshava Pavan
  2. 2. SKIN & VD 4-2-2013II. INDIAN CLASSIFICATIONNEURITIC TYPE  Nerve abscesses seen  Can be mono- or poly-neuriticINDETERMINATE TYPE  Vague, hypopigmented patches.  Beginning stage of the disease.  Can progress to either sides of the spectrum. *** Keshava Pavan

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