Leprosy- Not a stigma but a curable disease

Dr. Sakshi Srivastava, Consultant Dermatologist, Jaypee Hospital, Noida

New Delhi, January 29, 2018 : Leprosy commonly referred as Hansen’s disease is caused by a slow-growing type of bacteria called Mycobacterium leprae (M. leprae). The disease causes pale coloured disfiguring skin sores, lumps or bumps around the body that does not go away after several weeks or months. It also causes nerve damage leading to loss of feeling in the arms and legs and muscle weakness. Today, about 180,000 people worldwide are infected with leprosy, according to the World Health Organization, most of them in Africa and Asia. Leprosy encompasses erroneous customs and beliefs throughout history, banished people who suffered from the disease and compounded stigmatization and discrimination.

Erasing orthodox conviction towards leprosy entering your body via human touch, in reality it’s not that contagious. You catch it only if you come into close and repeated contact with nose and mouth droplet from someone with untreated Leprosy. Children are more likely to get leprosy than adults. The disease causing bacteria usually takes about 3-5 years for symptoms to appear after coming into contact with the bacteria. The time between contact with the bacteria and the appearance of symptoms is called the incubation period.

The condition primarily affects the peripheral nerves and secondarily involves skin and certain other tissues/organs, in particular the eyes, mucous of the nasal and upper respiratory tract. Delayed diagnosis and treatment of the disease can lead to serious complications. These can include disfigurement, hair loss particularly on the eyebrows and eyelashes, muscle weakness, permanent nerve damage in the arms and legs leading inability to use them. It also causes deep cracks on the feet also known as fisher feet, sudden pain in the joints, fever, and hypo pigmented skin lesions with severe ulceration. Additionally, it causes chronic nasal congestion, nosebleeds, and collapse of the nasal septum, iritis (inflammation of the iris of the eye), glaucoma (an eye disease that causes damage to the optic nerve). Leprosy can also pilot erectile dysfunction and infertility, and kidney failure.

Leprosy can be classified on the basis of clinical manifestations and skin smear results. In the classification based on skin smears, patients showing negative smears at all sites are said to have paucibacillary leprosy (PB), while those showing positive smears at any site are said to have multibacillary leprosy (MB).

Treatment for paucibacillary leprosy is with the medications dapsone and rifampicin for 6 months. Treatment for multibacillary leprosy consists of rifampicin, dapsone, and clofazimine for 12 months. A number of other antibiotics may also be used. In last 20 years, 16 million people with the disease have been cured and the WHO provides free treatment for Leprosy. It is no more to be considered a stigma as it is treatable via multidrug therapy.

The best way to prevent leprosy is to avoid long-term, close contact with an untreated, infected person. The overall outlook is good if your doctor diagnoses the leprosy promptly. Early treatment prevents tissue damage, stops the spread of the disease, and prevents serious health complications. If the diagnosis occurs at a more advanced stage, after an individual has significant disfigurement or disability then it may not be viable to lead a normal life despite treatment in these cases. Hence, early diagnosis is the best way to treat the disease.