Leprosy

• Leprosy spreads by skin to skin contact and by droplet spread .
• Neurological involvement is pronounced in Tuberculoid type of leprosy .
• Single skin lesion is seen in TT type of leprosy.
• Long contact with tuberculoid leprosy can transmit the disease .
• Slit skin smear, Fine needle aspiration cytology, Skin biopsy are used for diagnosis of Leprosy.
• Lepromin test is not used for the diagnosis of Leprosy.
• In the management of leprosy, lepromin test is most useful for prognosis.
• Exacerbation of lesions in patients of borderline leprosy is seen in  Lepra reaction type -I.
• Under leprosy eradication programme the managment of single lesion is Rifampicin, ofloxacin and minocycline single dose.
• Subtype of leprosy with maximum number of TH -1 cells is TT.
• Lepra cells found in lepromatous leprosy are Macrophages.
• In Leprosy most common renal lesion seen is MGN.
• Fastest acting drug in leprosy is Rifampicin.
• Kanamycin is not used in the treatment of leprosy.
• Drug causing icthyosis and hyperpigmentation, when used in leprosy is Clofazimine.
• Most common type of leprosy in India is TT.
• Skin smear is negative in Neuritic,Tuberculoid,Intermediate leprosy.
• Characteristic feature of borderline leprosy is inverted saucer lesion.
• Vesicles are not seen in Leprosy.
• Erythematous Macule, Hypo pigmented patch, Flat & raised patches may be seen in Leprosy.
• Gynaecomastia, Madarosis, Saddle nose, Leonine facies, Loss of libido and impotence are features of lepromatous leprosy.
• Commonest nerve involved in leprosy is Ulnar.
• In leprosy nerves commonly involved are high ulnar and low median.
• Abnormal EMG, voluntary muscle wasting, decreased response to tactile sensation may be seen in Leprosy.
• Decreased Proprioception is not seen in Leprosy.
• Leprosy do not involve CNS, uterus.
• Tuberculoid leprosy is characterised by non-caseating granuloma in nerve.
• Presence of globi, subepidermal free zone, decreased cell mediated immunity can be seen in Lepromatous Leprosy.
• Skin biopsy in leprosy is characterized by pariappendegial bacilli,pariappendegeal lymphocytosis, perivascular lymphocytosis.
• Lepromin test is positive in Tuberculoid leprosy.
• A 27-year-old patient was diagnosed to have borderline leprosy and started on multibacillary multi-drug therapy. Six weeks later, he developed pain in the nerves and redness and swelling of the skin lesions. The management of his illness should include all of the following:Continue Anti-leprosy Drugs,Costicosteroids, Analgesics, Rest to the limb.
• Best method of treatment of ulnar never abscess in case of leprosy is Incision and drainage.
• ENL is seen in LL form of leprosy.
• The first line antileprosy drugs include : Dapsone, Clofazimine, Rifampicin
• Side effect of clofazimine used in leprosy therapy is  Hyperpigmentation and Discolouration of body secretions.
• Control of TB and leprosy is by early diagnosis and treatment.
• WHO regime for paucibacillary leprosy:100 mg Dapsone daily + Rifampcin 600 mg monthly.
• Duration of treatment in pauci bacillary leprosy is 6 months.
• Average duration of treatment in multibacillary leprosy is 1 year.
• Prevalence of leprosy is decreasing in past decade in India.
• Insect can transmit Leprosy.
• Transplacental spread is not the mode of transmission of Leprosy.
• “Multibacillary” is a spectrum of disease, seen in Leprosy.
• Ridley jopling leprosy classification is a type of Clinical, bacteriological, immunological, histological classification.
• Lepromin test is negative in most of the child in 1st 6 month of life.
• BCG vaccination converts lepra reaction from negative to positive.
• A patient with leprosy had slightly erythematous, anesthetic plaques on the trunk and upper limbs. He was treated with paucibacillary multidrug therapy (PB-MDT) for 6 months. At the end of 6 months, he had persistent erythema and induration in the plaque. The next step of action recommended by the World Health Organization (WHO) in such a patient is to stop anti-leprosy treatment.
• Treatment of severe ulnar neuritis in borderline tuberculoid leprosy is MDT with steroids.
• For treatment of paucibacillary leprosy drugs used are Rifampicin and Dapsone.
• In multibacillary leprosy the follow up examination after adequate treatment should’be done yearly for 5 years.
• 2 yrs duration in terms of leprosy is with regard to post Rx surveillance of paucibacillary leprosy.
• Immunoprophylaxis of leprosy includes BCG and ICRC bacillus.
• Strategies in National Leprosy control program are early detection of cases; short course multi drug therapy;rehabilitation
• In leprosy eradication programme the multidrug therapy is not long term but short term therapy.
• Effective leprosy control programme may be indicated in : Decreased grade 2 disability,Low MDR resistant, multibacillary cases ,High new case detection rate.
• Elimination of leprosy is defined as prevalance < 1 per 10000.
• As per WHO, leprosy is a public health problem if prevalence is 0.01%.
• SET centres are established if prevalence leprosy is 1-5.
• National Leprosy Eradication Programme was started in 1983.
• Special Action Project for Elimination of leprosy is for rural areas.
• Trophic ulcers may be caused by Leprosy.
• Leprosy may lead to secondary Amyloidosis, Depressed bridge of nose, Septal perforation of nose.
• ‘Iris-pearls’ are seen in Leprosy.
• Ocular lesions of leprosy include : Avascular keratitis ,Interstitial keratitis , Neuroparalytic keratitis.
• Hansen (1874) described leprosy bacillus.
• Thalidomide is useful in treatment of type II lepra reaction.
• Foamy histocytes, Epitheliod cells, Noncaseating granulomas can be seen in histological examination in a case of Leprosy.
• Very numerous, symmetrically distributed, erythematous or copper coloured shiny macules/papule are feature of LL.
• More than 5 lesions on skin smears seen in Multibacillary Leprosy.
• Clofazimine is an important drug to be given in Multibacillary Leprosy.
• Asmmetrical several nerves thickening with several hypoesthetic macules on skin indicates Borderline borderline stage of leprosy.
• Most important in establishing diagnosis of leprosy is Slit smear for AFB.
• Innumerable, small, normoesthetic and symmetrical skin lesions are present in Lepromatous type of leprosy.
• The fingerprint pattern may be impaired permanently in case of Leprosy.
• Globi in leprosy consist of AFB with macrophages.
• Leprosy is not targeted for global eradication because of long incubation period.
• Multiple hypoaesthetic, hypopigmented macules on right lateral forearm with numerous acid fast bacilli is indicative of Borderline Leprosy.
• Patient with leprosy, smear sample taken show 10 – 100 bacilli in one field. Bacterial index is 4+.
• Ulceronecrotic nodule is seen in Lucio Leprosy.
• Nerves are not involved in Indeterminate Leprosy.
• If a claw hand develops in a patient with Leprosy, the deformity is Grade II.
• Most sensitive index of transmission in leprosy is Incidence.

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