Leprosy

Description:

Leprosy (Hansen's disease, хансеноз, хансениаз; outdated names — leprosy, elephantiasis graecorum, lepra arabum, lepra orientalis, a Phoenician disease, satyriasis, a mournful disease, a krymka, lazy death, Saint Lazar's disease, etc.) — the chronic granulomatosis (a chronic infectious disease) caused by Mycobacterium leprae mycobacteria, proceeding with preferential damage of skin, a peripheral nervous system, sometimes an anterior chamber of an eye of upper respiratory tracts are higher than a throat, testicles, and also brushes and feet.

Leprosy symptoms:

Generally at leprosy the body tissues cooled by air are surprised: skin, a mucous membrane of upper airways and superficially located nerves. In not treated cases infiltration of skin and destruction of nerves can lead to the expressed deformation of an appearance and ugliness. However mycobacteria of a leprosy are not capable to cause dying off of fingers of a brush or foot. The consecutive bacterial infection leads to loss of parts of a body as a result of a necrosis of fabrics when the fabrics deprived of sensitivity are exposed to injuries that remains unnoticed and not cured. Allocate two polar types of a disease (tuberculoid and lepromatous), boundary and uncertain. Uncertain leprosy usually begins with damage of skin. The centers are almost imperceptible. As the first symptom usually serves paresthesia or a hyperesthesia on any site of skin. At attentive survey it is possible to find hypo here - or the hyper pigmented spot, one or several. Rashes can independently be resolved in one-two years.
Tuberculoid leprosy. Tuberculoid leprosy usually begins emergence of accurately outlined hypopigmented spot within which the hyperesthesia is noted. Further the spot increases, its edges rise, become valikoobrazny with the ring-shaped or spiral-shaped drawing. The central part of a spot is exposed to an atrophy and sinks down. Within this center skin is deprived of sensitivity, there are no sweat glands and hair follicles. Near a spot reinforced nerves, the innervating affected areas are usually palpated. Damage of nerves leads to an atrophy of muscles; especially brush muscles suffer. Contractures of brushes and feet are frequent. Injuries and prelums lead to an infection of brushes and feet, on soles neurotrophic ulcers are formed. Further mutilation of phalanxes is possible. At defeat of a facial nerve the lagophthalmia and the keratitis caused by it, and also an ulcer the Lepromatous leprosy meet. The lepromatous leprosy usually is followed by damages of skin, extensive and symmetric concerning a body midline. The centers of defeat can be presented by spots, plaques, papules, nodes (lepromas). They have indistinct borders, the dense and convex center. Skin between elements is thickened. Most often the face, auricles, wrists, elbows, buttocks and knees suffer. A characteristic sign — loss of an outside third of eyebrows. Are characteristic of late stages of a disease "the lion's person" (distortion of features and disturbance of a mimicry because of a skin thickening), growth of lobes of ears. As the first symptoms of a disease often serve the nose congestion, nasal bleedings, the complicated breath. Full impassability of nasal ways, laryngitis, hoarseness is possible. Perforation of a nasal partition and deformation of cartilages lead to retraction of a ridge of the nose (a saddle nose). Penetration of the activator into an anterior chamber of an eye leads to a keratitis and an iridocyclitis. Inguinal and axillary lymph nodes are increased, but are not painful. Men have an infiltration and a sclerosis of fabric of testicles lead to infertility. Often the gynecomastia develops. Are characteristic of late stages of a disease a giposteziya of peripheral departments of extremities. At a biopsy of skin find a diffusion granulematozny inflammation.
Boundary types of leprosy on the manifestations stand between polar types.

Leprosy reasons:

Infestant - Mycobacterium leprae mycobacteria. The leprosy is transmitted through a discharge from a nose and a mouth during close and frequent contacts with the people who are not undergoing treatment. The incubation interval usually makes three-five years, but can fluctuate from six months to several decades (the incubation interval lasting 40 years is described. It proceeds asymptomatically. Also not less long stage of latency, not specificity and a non-obligation of antecedent signs (an indisposition, weakness, drowsiness, paresthesia, feeling of a chill) is characteristic of a leprosy that considerably complicates early diagnosis of a disease.

Treatment of the Leprosy:

Treatment of leprosy demands participation of many specialists. In addition to antimicrobic therapy consultations of the orthopedist, the ophthalmologist, the neuropathologist, the physiotherapist can be necessary. Antileprotic therapy is performed by means of the following means: dapsone, rifampicin, clofazimine; recently antileprotic activity of minocycline, an ofloksatsin and klaritromitsin is found.