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Synonyms of Leprosy
- Hansen's Disease
- Borderline Lepromatous Leprosy
- Borderline Tuberculoid Leprosy
- Indeterminate Leprosy
- Lepromatous Leprosy
- Midborderline Leprosy
- Tuberculoid Leprosy
Leprosy is a chronic infectious disease of humans caused by the bacteria Mycobacterium leprae. For many years, it was considered a mysterious disorder associated with some type of curse, and persons with the disease were isolated and ostracized. Today, there is effective treatment and the disease can be cured. There is no longer any justification for isolating persons with leprosy.
The disease can affect the skin, mucous membranes, and eyes and some of the nerves that are located outside the central nervous system (peripheral nerves). These are primarily the nerves of the hands, feet, and eyes, and some of the nerves in the skin. In severe, untreated cases, loss of sensation, muscle paralysis of hands and feet, disfigurement, and blindness may occur.
Leprosy has traditionally been classified into two major types, tuberculoid and lepromatous. Patients with tuberculoid leprosy have limited disease and relatively few bacteria in the skin and nerves, while lepromatous patients have widespread disease and large numbers of bacteria. Tuberculoid leprosy is characterized by a few flat or slightly raised skin lesions of various sizes that are typically pale or slightly red, dry, hairless, and numb to touch (anesthetic). Lepromatous leprosy is at the other end of the spectrum, with a much more generalized disease, diffuse involvement of the skin, thickening of many peripheral nerves, and at times involvement of other organs, such as eyes, nose, testicles, and bone. There are also intermediate subtypes between these two extremes that are commonly known as borderline leprosy. The intermediate subtypes are borderline tuberculoid, midborderline, and borderline lepromatous leprosy. Borderline leprosy and the subtypes are characterized by more extensive disease than polar tuberculoid, with more numerous skin lesions and more nerve involvement, but not as widespread disease as in lepromatous leprosy. Indeterminate leprosy refers to a very early form of leprosy that consists of a single skin lesion with slightly diminished sensation to touch. It will usually progress to one of the major types of leprosy.
In 1982, the World Health Organization proposed a simplified classification that has only two classifications, Paucibacillary (PB) and Multibacillary (MB), leprosy. This classification is now used worldwide for treatment purposes. The older and somewhat more complex classification is still used in some programs, especially for clinical research studies. The Paucibacillary classification encompasses indeterminate, tuberculoid and borderline tuberculoid leprosy. The Multibacillary classification includes midborderline, borderline lepromatous and lepromatous leprosy.
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