Highlights & Basics
- Leprosy is a chronic infectious disease caused by the acid-fast bacteria Mycobacterium leprae and M lepromatosis, characterized by skin lesion(s) and involvement of peripheral nerves.
- Skin lesions can be erythematous or hypopigmented, single or multiple macules, papules, or nodules, sometimes with loss of sensation.
- Skin smear may or may not be positive for acid-fast bacilli (AFB) depending on the classification (multibacillary vs. paucibacillary).
- Nerve damage to peripheral nerve trunks may occur, with loss of sensation in the skin and weakness of muscles supplied by the affected nerve, leading to disabilities.
- Diagnosis is most commonly based on clinical signs and symptoms, and in practice, people usually report on their own to the health center.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
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Citations
World Health Organization. Towards zero leprosy. Global leprosy (Hansen's Disease) strategy 2021-2030. Apr 2021 [internet publication].[Full Text]
World Health Organization. Implementation of MDT. In: Multidrug therapy against leprosy: development and implementation over the past 25 years. Geneva: World Health Organization; 2004:45-68.[Full Text]
World Health Organization. Guidelines for the diagnosis, treatment and prevention of leprosy. Oct 2018 [internet publication].[Full Text]
World Health Organization. Leprosy/Hansen disease: management of reactions and prevention of disabilities. 2020 [internet publication].[Full Text]
1. World Health Organization. Towards zero leprosy. Global leprosy (Hansen's Disease) strategy 2021-2030. Apr 2021 [internet publication].[Full Text]
2. Ridley DS Jopling.WH. Classification of leprosy according to immunity: a five-group system. Int J Lepr Other Mycobact Dis. 1966;34:255-73.[Abstract]
3. World Health Organization. Implementation of MDT. In: Multidrug therapy against leprosy: development and implementation over the past 25 years. Geneva: World Health Organization; 2004:45-68.[Full Text]
4. Han XY, Jessurun J. Severe leprosy reactions due to Mycobacterium lepromatosis. Am J Med Sci. 2013;345:65-9.[Abstract][Full Text]
5. Kamath S, Vaccaro SA, Rea TH, et al. Recognizing and managing the immunologic reactions in leprosy. J Am Acad Dermatol. 2014;71:795-803.[Abstract]
6. World Health Organization. Leprosy. Jan 2022 [internet publication].[Full Text]
7. Centers for Disease Control and Prevention. Hansen's disease (leprosy). Feb 2017 [internet publication].[Full Text]
8. Cole ST, Eiglmeier K, Parkhill J, et al. Massive gene decay in the leprosy bacillus. Nature. 2001;409:1007-1011.[Abstract][Full Text]
9. Han XY, Sizer KC, Tan HH. Identification of the leprosy agent Mycobacterium lepromatosis in Singapore. J Drugs Dermatol. 2012;11:168-172.[Abstract]
10. Scollard DM, Adams LB, Gillis TP, et al. The continuing challenges of leprosy. Clin Microbiol Rev. 2006;19:338-381.[Abstract][Full Text]
11. Rees RJ, McDougall AC. Airborne infection with Mycobacterium leprae in mice. J Med Microbiol. 1977;10:63-68.[Abstract]
12. Chehl S, Job CK, Hastings RC. Transmission of leprosy in nude mice. Am J Trop Med Hyg. 1985;34:1161-1166.[Abstract]
13. Araujo S, Freitas LO, Goulart LR, et al. Molecular evidence for the aerial route of infection of mycobacterium leprae and the role of asymptomatic carriers in the persistence of leprosy. Clin Infect Dis. 2016 Dec 1;63(11):1412-20.[Abstract][Full Text]
14. Truman RW, Singh P, Sharma R, et al. Probable zoonotic leprosy in the southern United States. N Engl J Med. 2011;364:1626-1633.[Abstract][Full Text]
15. Avanzi C, Del-Pozo J, Benjak A, et al. Red squirrels in the British Isles are infected with leprosy bacilli. Science. 2016 Nov 11;354(6313):744-47.[Abstract]
16. Hockings KJ, Mubemba B, Avanzi C, et al. Leprosy in wild chimpanzees. Nature. 2021 Oct;598(7882):652-6.[Abstract][Full Text]
17. Yamamura M, Uyemura K, Deans RJ, et al. Defining protective responses to pathogens: cytokine profiles in leprosy lesions. Science. 1991;254:277-279.[Abstract]
18. Mi Z, Liu H, Zhang F. Advances in the immunology and genetics of leprosy. Front Immunol. 2020;11:567.[Abstract][Full Text]
19. Mira MT, Alcaïs A, Nguyen VT, et al. Susceptibility to leprosy is associated with PARK2 and PACRG. Nature. 2004;427:636-640.[Abstract]
20. Misch EA, Berrington WR, Vary JC Jr, et al. Leprosy and the human genome. Microbiol Mol Biol Rev. 2010;74:589-620.[Abstract][Full Text]
21. Guinto RS, Rodriguez JN, Doull JA, et al. The trend of leprosy in Cordova and Talisay, Cebu Province, Philipines. Int J Lepr. 1954;22:409-430.[Abstract]
22. Noordeen SK, Neelan PN. Extended studies on chemoprophylaxis against leprosy. Indian J Med Res. 1978;67:515-527.[Abstract]
23. World Health Organization. Weekly epidemiological record. 2019;94(35/36):389-412.[Full Text]
24. Setia MS, Steinmaus C, Ho CS, et al. The role of BCG in prevention of leprosy: a meta-analysis. Lancet Infect Dis. 2006;6:162-170. [Abstract]
25. Zodpey SP. Protective effect of bacillus Calmette Guerin (BCG) vaccine in the prevention of leprosy: a meta-analysis. Indian J Dermatol Venereol Leprol. 2007;73:86-93.[Abstract]
26. Zodpey SP. The BCG controversy: a reappraisal of the protective effect against tuberculosis and leprosy. Indian J Public Health. 2004;48:70-77.[Abstract]
27. Kartikeyan S, Chaturvedi RM, Deo MG. Anti-leprosy vaccines: current status and future prospects. J Postgrad Med. 1991;37:198-204.[Abstract][Full Text]
28. Richardus JH, Tiwari A, Barth-Jaeggi T, et al. Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme. Lancet Glob Health. 2021 Jan;9(1):e81-90.[Abstract][Full Text]
29. World Health Organization.Leprosy/hansen disease: contact tracing and post-exposure prophylaxis. World Health Organization: Regional office for South-East Asia;2020.[Full Text]
30. Levy L, Shepard CC, Fasal P. The bactericidal effect of rifampicin on M. leprae in man: a) single doses of 600, 900 and 1200 mg; and b) daily doses of 300 mg. Int J Lepr Other Mycobact Dis. 1976 Jan-Jun;44(1-2):183-7.[Abstract]
31. Montestruc E, Berdonneau R. Two cases of leprosy in infants in Martinique [in French]. Bull Soc Pathol Exot Filiales. 1954;47:781-783.[Abstract]
32. Santos DFD, Mendonça MR, Antunes DE, et al. Revisiting primary neural leprosy: clinical, serological, molecular, and neurophysiological aspects. PLoS Negl Trop Dis. 2017 Nov;11(11):e0006086.[Abstract][Full Text]
33. Pitta IJR, Hacker MAV, Andrade LR, et al. Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil. PLoS Negl Trop Dis. 2022 Jan;16(1):e0010070.[Abstract][Full Text]
34. World Health Organization. Guidelines for the diagnosis, treatment and prevention of leprosy. Oct 2018 [internet publication].[Full Text]
35. Maymone MBC, Venkatesh S, Laughter M, et al. Leprosy: treatment and management of complications. J Am Acad Dermatol. 2020 Jul;83(1):17-30.[Abstract]
36. Lazo-Porras M, Prutsky GJ, Barrionuevo P, et al. World Health Organization (WHO) antibiotic regimen against other regimens for the treatment of leprosy: a systematic review and meta-analysis. BMC Infect Dis. 2020 Jan 20;20(1):62.[Abstract][Full Text]
37. European Medicines Agency. Quinolone- and fluoroquinolone-containing medicinal products. Mar 2019 [internet publication].[Full Text]
38. US Food and Drug Administration. FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. Dec 2018 [internet publication].[Full Text]
39. US Food and Drug Administration. FDA reinforces safety information about serious low blood sugar levels and mental health side effects with fluoroquinolone antibiotics; requires label changes. Oct 2018 [internet publication].[Full Text]
40. Liu H, Wang Z, Bao F, et al. Evaluation of prospective HLA-B*13:01 screening to prevent dapsone hypersensitivity syndrome in patients with leprosy. JAMA Dermatol. 2019 Jun 1;155(6):666-72.[Abstract][Full Text]
41. World Health Organization. Leprosy/Hansen disease: management of reactions and prevention of disabilities. 2020 [internet publication].[Full Text]
42. Van Veen NH, Nicholls PG, Smith WC, et al. Corticosteroids for treating nerve damage in leprosy. Cochrane Database Syst Rev. 2016 May 23;(5):CD005491.[Abstract][Full Text]
43. Perez-Molina JA, Arce-Garcia O, Chamorro-Tojeiro S, et al. Use of methotrexate for leprosy reactions. Experience of a referral center and systematic review of the literature. Travel Med Infect Dis. 2020 Sep - Oct;37:101670.[Abstract]
44. WHO Expert Committee on Leprosy. 7th report. World Health Organ Tech Rep Ser. 1998;874:20.[Abstract][Full Text]
45. Manickam P, Nagaraju B, Selvaraj V, et al; Team of Study Investigators. Efficacy of single-dose chemotherapy (rifampicin, oflaxacin and minocycline-ROM) in PB leprosy patients with 2 to 5 skin lesions, India: randomised double-blind trial. Indian J Lepr. 2012;84:195-207.[Abstract]
46. Cunha Mda G, Virmond M, Schettini AP, et al. OFLOXACIN multicentre trial in MB leprosy FUAM-Manaus and ILSL-Bauru, Brazil. Lepr Rev. 2012;83:261-268.[Abstract]
47. International Leprosy Association. Report of the International Leprosy Association Technical Forum: Paris, France, 22-28 February 2002. Int J Lepr Other Mycobact Dis. 2002;70(suppl):S1-62.[Abstract]
48. Consigny S, Bentoucha A, Bonnafous P, et al. Bactericidal activities of HMR 3647, moxifloxacin, and rifapentine against Mycobacterium leprae in mice. Antimicrob Agents Chemother. 2000;44:2919-2921.[Abstract][Full Text]
49. Andries K, Verhasselt P, Guillemont J, et al. A diarylquinoline drug active on the ATP synthase of Mycobacterium tuberculosis. Science. 2005;307:223-227.[Abstract]
50. WHO Expert Committee on Leprosy. 8th report. World Health Organ Tech Rep Ser. 2012;968:1-61.[Abstract][Full Text]
51. Rajkumar P, Chethrapilly Purushothaman GK, Ponnaiah M, et al. Low risk of relapse and deformity among leprosy patients who completed multi-drug therapy regimen from 2005 to 2010: a cohort study from four districts in South India. PLoS Negl Trop Dis. 2021 Nov;15(11):e0009950.[Abstract][Full Text]
52. International Federation of Anti-Leprosy Associations. ILEP learning guide 4: how to prevent disability in leprosy. 2006 [internet publication].[Full Text]
