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LEPROSY DIAGNOSIS

 HARISH.K.E

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CLINICAL DIAGNOSIS
• Most of cases can be diagnosed only with
proper clinical examination alone.
• CASE TAKING in leprosy has two
components
• 1) Interrogation
biodata,family h/o leprosy,Contact
with leprosy patient
• 2) Physical examination
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1. Thorough inspection of body

PHYSICAL EXAMINATION

2. Palpation of commonly involved

peripheral nerves like ulnar nerve
near medial epicondyl
3. Testing for loss of sensation of heat
or cold ,pain,touch.
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BACTERIOLOGICAL EXAMINATION
Specimen:
1) skin smear – skin from site of lesion and
one of the ear lobe by slit and scrape method.
2) nasal smear – early morning mucus
material
3)nasal scrapping- Not used often as it is
painful

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BACTERIAL INDEX
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MORPHOLOGICAL
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• The percentage of solid stained bacilli in a

stained smear is MI
• Criteria for solid rod bacilli
1. Uniform staining of entire organism
2. Parallel sides
3. Rounded ends
4. Length 5 times width
(only solid bacilli are viable) 7 7
SFG to–solid
Click fragmented
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• Percentages of solid,fragmented and granular
bacilli
• SFG gives better picture of bacterial
morphology than MI

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FOOT PAD
to edit CULTURE
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In foot pad of mice . But highly time
consuming

• HISTAMINE TEST
Reliable for detecting early stage
peripheral nerve damage due to leprosy. Intradermal
injection of 0.1ml of 1:1000 sol of histamine
phosphate into hypopigmented patch.
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NORMAL Master
PERSON title style
– wheal surrounded by erythematoud
flare in few minutes(triple response)

CASE OF LEPROSY -no flare response as nerve supply

destroyed

BIOPSY –bacterial content in skin

IMMUNOLOGICAL TESTS

Test for CMI

Test for humoral immunity 1010
CMI tests
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LEPROMINE TEST
Intradermal injection of 0.1ml lepromin into
inneraspect of forearm .
Read after 48 hrs and 21 days .
EARLY (FERNANDEZ) REACTION
If diameter of red area more than 10mm after
48 hrs it is positive
LATE (MITSUDA) REACTION
If diameter of nodule more than 5mm after
21 days it is positive. 11
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Lepromin titlediagnostic
test is not style test

It is a tool in evaluating CMI of leprosy patients

Helps to classify type of disease

Strongly positive – TUBERCULOID LEPROSY

Negative –LEPROMATOUS LEPROSY

OTHER METHODS
LTT –lymphocyte transformation test
LMIT-leucocyte migration inhibition test
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Tests
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edithumoral immune
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1. FLA – ABS test (fluorescent leprosy

antibody absorption test)
2. Monoclonal antibodies
3. ELISA/Radio immune assay

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Reference Master titleand
:preventive style
social medicine by
K.PARK

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THANK YOU

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