LEPROSY

MICHAELLA E. BUSTILLOS
•Hansen’s disease
•A chronic systemic infection
characterized by progressive
cutaneous lesions.
ETIOLOGY
• Causal organism is Mycobacterium leprae
• It resembles the Tubercle bacillus
• Leprosy bacilli may be found by making acid-
fast stains of materials from lesions of the
skin and lymph nodes.
•LESIONS are the
sources of infection
MODE OF TRANSMISSION
• Exact MOT is unknown, but probably enter the
body through the skin or mucous membrane
• Can be transmitted through respiratory droplets
• Cats and dogs may play a part in the transfer of
the disease
TYPES
• LEPROMATOUS
- Formation of nodules in the skin and mucous
membrane
• TUBERCULOID
- formation of patches on the surface of the body and by
nerve lesions.
• BORDERLINE (Dimorphous) Leprosy
- has the characteristics of both lepromatous and
tuberculoid. Skin lesions of this type are diffused and poorly
defined.
PATHOLOGY
• Mycobacterium leprae attacks the peripheral
nerves, especially the ulnar, radial, posterior-
popliteal, anterior-tibial and facial nerves.
• When the bacilli damage the skin’s fine nerves,
they cause anesthesia, anhidrosis, and dryness.
• If they did attack a large nerve trunk, motor nerve
damage, weakness and pain occur, followed by
peripheral anesthesia, muscle paralysis and
atrophy.
•Incubation period is prolonged
and undetermined, probably from
a few months to 25 years.
•Average is 2-3 years.
•Ranges from five and a half
months to eight years.
COURSE OF THE DISEASE
1. LEPROMATOUS LEPROSY
• Nodules appear in crops on the skin, usually on the hands,
feet, and face.
• Gradually skin thickens, eyebrows disappear, some of the
nodules ulcerate, while others are absorbed.
• This type of leprosy produces a peculiar thickening of the
skin on the forehead and cheeks, becoming a lion like
appearance.
• Patient may live ten or twenty years.
2. TUBERCULOID LEPROSY
• Have no prodromal symptoms except neuritis.
• Trophic ulcers appear on the feet and hands, fingers and
toes undergo total atrophy, and blisters appear on the
trunk.
• Final stage is accompanied by facial paralysis and
gangrene of the feet.
• Patient may live for thirty or forty years.
COMPLICATIONS
• Hemorrhage • Neuritis
• Pneumonia • Mutilation of the
• Tuberculosis features and the
• Gangrene limbs.
• Aphonia • Blindness
DIFFERENTIAL DIAGNOSIS
• HISTAMINE TEST is used to differentiate tuberculoid
leprae from syringomyelia and other diseases.
• Diagnosis is made by smears from the mucous
membranes and by making sections of suspected
lesions.
• Tissue biopsy
• Blood tests show increased RBC & ESR; decreased
serum calcium, albumin and cholesterol levels.
PERIOD OF COMMUNICABILITY

•Is communicable from the time

the open lesions begin to
discharge bacilli until the lesions
are healed.
METHODS OF CONTROL
• RECOGNITION AND REPORTING – disease is
recognized by the clinical symptoms, and is
confirmed by laboratory diagnosis.
• ISOLATION
• QUARANTINE
• IMMUNIZATION
• INVESTIGATION OF SOURCES OF
INFECTIONS
NURSING CARE
• ISOLATION
• PERSONAL HYGIENE – should be taught good
habits of personal hygiene. Facilities for daily baths
and clean clothing should be provided.
• MENTAL HYGIENE – should help the patients to
adjust to the present enforced isolation through her
attitude of assurance and cheerfulness.
• DIET – should be highly nourishing, and high in
vitamin content.
• CHEMOTHERAPY – when Diasone, Promin and
Promazole are used, the nurse should be alert for
symptoms of toxic reactions.
• DISINFECTION – in the home linen should be
boiled for 15 minutes.
– food waste and handkerchiefs
containing nose & throat secretions should be
burned.
 – the unit should be thoroughly
cleaned with soap and water upon the death or
discharge of the patient.
• ESSENTIAL POINTS TO REMEMBER
– Hansen’s disease is communicable only under
special conditions.
– patients whose lesions are healed are paroled,
and they must report to the health authorities in
their home communities at stated intervals, usually
every 6 months.
– the infection usually is contracted in childhood.
NURSING DIAGNOSIS
• Impaired skin • Knowledge deficit
integrity • Anxiety
• Social isolation • Impaired body image
• Ineffective coping