Lepra (synonym for leprosy) is a slightly contagious chronic infectious disease that affects the skin, visible mucous membranes, the peripheral nervous system and internal organs.
Lepra is found in all parts of the world; in the USSR — mainly in Central Asia, in the Astrakhan Region, in the Caucasus, the Far East, and in the Baltic States. Acid-resistant mycobacterium, very similar to the causative agent of tuberculosis, causes the disease. Infection occurs through the skin or nasal mucosa with prolonged contact with patients. The most susceptible children. The incubation period is several years. The disease lasts for many years, sometimes severely exacerbated.
Fig. 6. Undifferentiated leprosy.
Fig. 7. Lepromatous leprosy.
Fig. 8. Tuberculoid leprosy.
There are three types of leprosy. In the case of lepromatous type of leprosy (Fig. 7), reddish-brown spots without clear boundaries, infiltrates, tubercles and nodes with a greasy surface appear mainly on the skin of the extremities and face. eyebrows and eyelashes fall out, ear lobes thicken, nose deforms; ulcers appear on the mucous membranes of the mouth and nose, the voice becomes hoarse, shortness of breath , neuritis, visual disturbance to blindness, lymphadenopathy develop. The liver and spleen are often enlarged, dense, painless; in advanced cases, the testicles and appendages are affected; lepromas are formed in the phalangeal bones (see Granuloma), in the long bones - osteoperiostitis (inflammatory process in the bone, which engages the periosteum).Go
With undifferentiated leprosy (Fig. 6), the spots are often annular, dry, and have no surface sensitivity. Nervous trunks (elbow, peroneal, etc.) are thickened, painful; in the lesions, the sensitivity disappears, atrophies, contractures, trophic ulcers on the soles, lagophthalmos (eyelid closure) develop, phalangeal bones dissolve.
For the recognition of leprosy, it is important to indicate residence in the endemic zone, the presence of relatives with leprosy. If leprosy is suspected, it is necessary to inspect the entire skin, mucous membranes of the nose and mouth, examine the scraping of the mucous membrane of the nasal septum and the tissue juice from skin rashes (acid resistant bacilli are easily detected only in the lepromatous type); using a sharp needle, test tubes with cold and hot water to establish the presence of anesthesia on the rash and in the distal extremities.
The prognosis is serious: a neglected disease leads to blindness and severe disability, and sometimes to death. Lepra is curable, especially with early treatment, but leprosy treatment continues for many years.
Treatment with sulfonic and other preparations is carried out at the direction of leprosy specialists. If a leprosy is suspected, the patient should be referred immediately to a dermatologist. Contagious patients must be sent to leprosariums (closed medical institutions such as agricultural colonies), where they are treated. After the disappearance of the bacilli, patients are discharged for outpatient treatment at the place of residence. Patients transferred to outpatient treatment are not dangerous to others. The fight against leprophobia is very important.
Prevention : all members of the patient’s family and people in contact with him undergo periodic medical examinations. In areas of the greatest distribution of leprosy, all residents undergo a medical examination.