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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Leprosy

Hansen's disease

Last reviewed: August 24, 2011.

Leprosy is a disease that has been known since biblical times. It causes skin sores, nerve damage, and muscle weakness that gets worse over time.

Causes, incidence, and risk factors

Leprosy is caused by the bacterium Mycobacterium leprae. It is not very contagious and it has a long incubation period (time before symptoms appear), which makes it hard to know where or when someone caught the disease. Children are more likely than adults to get the disease.

Leprosy has two common forms: tuberculoid and lepromatous. Both forms produce sores on the skin. However, the lepromatous form is most severe. It causes large lumps and bumps (nodules).

Leprosy is common in many countries worldwide, and in temperate, tropical, and subtropical climates. About 100 cases per year are diagnosed in the United States. Most cases are in the South, California, Hawaii, and U.S. islands.

Effective medications exist. Isolating people with this disease in "leper colonies" is not needed.

Drug-resistant Mycobacterium leprae and an increased numbers of cases worldwide has led to global concern about this disease.

Symptoms

Symptoms include:

Signs and tests

Treatment

A number of different antibiotics (including dapsone, rifampin, clofazamine, fluoroquinolones, macrolides, and minocycline) are used to kill the bacteria that cause the disease. More than one antibiotic is often given together.

Aspirin, prednisone, or thalidomide is used to control inflammation.

Expectations (prognosis)

Diagnosing the disease early is important. Early treatment limits damage, prevents a person from spreading the disease, and allows the person to have a normal lifestyle.

Complications

  • Disfigurement
  • Muscle weakness
  • Permanent nerve damage in the arms and legs

People with long-term leprosy may lose the use of their hands or feet due to repeated injury because they lack feeling in those areas.

Calling your health care provider

Call your health care provider if you have symptoms of leprosy, especially if you've had contact with someone who has the disease. Cases of leprosy in the United States need to be reported to the Centers for Disease Control and Prevention.

Prevention

Prevention consists of avoiding close physical contact with untreated people. People on long-term medication become noninfectious (they do not transmit the organism that causes the disease).

References

  1. 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.
  2. Ernst JD. Leprosy (Hansen's disease). In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 334.

Review Date: 8/24/2011.

Reviewed by: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Decompressive surgery for treating nerve damage in leprosy
    Leprosy is a chronic infectious disease. Leprosy bacteria cause damage to skin and peripheral nerves which may result in nerve function impairment and disability. Decompressive surgery is used for treating nerve damage although its effect is uncertain. Two randomised controlled trials (RCTs) were included in the review and examined the added benefit of surgery over prednisolone for treatment of nerve damage of less than six months duration. Both trials were at high risk of bias. Two years from the start there was very low quality evidence of no significant difference in nerve function improvement between people treated with surgery plus prednisolone or with prednisolone alone. Adverse effects of decompressive surgery were not adequately described. No additional trials were identified when searches were updated in 2010 and 2012. Decompressive surgery is used for treating nerve damage in leprosy but the available evidence from RCTs is of very low quality and does not show a significant added benefit of surgery over steroid treatment alone. Well‐designed RCTs are needed to establish the effectiveness of the combination of surgery and medical treatment compared to medical treatment alone.
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