leprosy - part 1 - a presentation at

LEPROSY

PART 1

Pradnya Gogate B. Optom,

To view more presentations and articles, visit www.eyenirvaan.com

LEPROSY

Hansen’s disease

Chronic, granulomatous Etiology: Mycobacterium leprae Male: Female ratio –2:1 Transmission in nasal discharge, contact


CLASSIFICATION

Tuberculoid

Lepromatous

Borderline/ Dimorphous


TUBERCULOID Benign Distribution: Face, skin, gluteal region,

limbs Asymmetrical lesions, anhydrotic Polyneuritis Claw hand, foot drop Nerves involved Eg. Ulnar, peroneal Loss of sensation


LEPROMATOUS Macular, diffuse nodular Distribution: Face, ear lobes, neck, extremities,

trunk

Borderline

Intermediate between lepromatous & tuberculoid Bizarre skin lesions (eyes, nose)


LEPRA REACTIONS

Inflammation in pre-existing lesions Type I: Borderline & tuberculoid Mechanism: Cell mediated

hypersensitivity Occurs spontaneously, loss of nerve

function, swollen skin lesions Type II: Common in 2nd year of treatment Fever, painful papules/nodules(erythema

nodosum leprosum)


OCULAR FEATURES

Conjunctivitis Keratitis Loss of eyelash/ eyebrows Scleritis Corneal anaesthesia Iritis (lepromatous) Severe miosis, iris atrophy


LEPROMATOUS IRITIS


INVESTIGATIONS

Slit skin smear: Lesions from ear lobe, ring/middle finger

Lepromin test (suspension of dead M.leprae) Classify disease, determine

prognosis/treatment


MANAGEMENT

Isolation of patient till non-infectious Three drug therapy: Rifampicin Clofazimine 50mg/day Dapsone 2mg/kg/day Chemotherapy for lepra reactions:

Thalidomide 100mg/6hrs Aspirin 600mg/6hrs Steroids


PREVENTION

Avoid contact

Regular treatment

Follow up

Improve socio-economic conditions


CONTINUE TO PART II …

THANK YOU


leprosy - part 1 - a presentation at

Health & Medicine