Leprosy - a chronic infectious disease caused by acid-fast bacilli of leprosy (Mycobacterium leprae-Neisser). If the infection affects mainly the skin, peripheral nervous system, eyes, and internal organs. In the world of leprosy patients are now number more than two million. Men suffer from this disease are twice as likely as women. Leprosy ill at any age, but children under one year rarely get sick.
The disease leprosy little contagious. The only reservoir of leprosy - a sick man. Of infection occurs by droplets or by direct contact with the patient.
Clinical symptoms of leprosy
Immunological and clinical manifestations of the disease are characterized by great diversity (from tuberculoid to lepromatous form of the infection)
. The first symptoms of leprosy usually appear on the skin of the person in the form of one or more hypopigmented or hyperpigmented plaques or spots
. On the site of skin lesions often accompanied by partial or complete loss of sensation
. After contact with a sick person to a healthy skin may appear isolated lesions with reduced sensitivity
. Affected skin may spontaneously resolved within a few years, but in this embodiment, can not do without specific treatment
. For early tuberculoid leprosy appear clearly delineated spots of hypopigmentation of the skin
. Later, the lesions grow, their edges are rounded and lifted acquiring annular shape
. The defeat of the nerves leads to muscle atrophy
. Very often develop contractures of foot and hand
. The defeat of the facial nerve often leads to lagophthalmos, keratitis and ulceration of the cornea, leading to blindness
When lepromatous leprosy lesions presented hypopigmented spots, knots, plaques or papules. The boundaries of lesions clear outlines, their departments and the central slightly raised above the surface of the skin, bulging and seals, not concave, as in tuberculoid leprosy. Between the lesions usually observed diffuse infiltration. The favorite sites of localization of lesions in the lepromatous leprosy deemed ears, face (eyebrows, cheeks, nose), elbows, wrists, knees and buttocks. At this stage, the disease often fall lateral portions eyebrows droop and later earlobes and face skin shrinks and thickens (lion face).
Early symptoms of leprosy are shortness of breath, nosebleeds, hoarseness, laryngitis and nasal obstruction. With the defeat of the anterior part of the eye develop iridocyclitis and keratitis. Men scarring and testicular infiltration lead to infertility. A very common symptom of leprosy is the development of saddle nose as a result of the perforation of the nasal septum and the formation of a small depression in the middle of the back of the nose.
The treatment of leprosy
In 1943, for the treatment of leprosy were offered sulfone drugs. In addition to them, the compound administered ethyl mercaptan derivatives or thiourea derivatives of antibiotic Rifadin and isonicotinic acid.
Antibiotics Rifadin highly protivoleproznoy activity and good tolerability when taken orally. The antibiotic is easily absorbed from the digestive tract, penetrate into the tissues of the body. This preparation is particularly effective in lepromatous leprosy. It provides fast to negative bacteriological.
The treatment of leprosy should be carried out by several drugs. Usually it Rifadin, Clofazimine and dapsone. A combination of dapsone and Rifadina be quite effective for border and border lepromatous form of the disease. When lepromatous form of the disease, it is desirable to use all three drugs. In the course of the treatment of leprosy should apply objective methods of evaluating the effectiveness of the therapy, including biopsies and scrapings. Treatment for the disease should continue as long as using laboratory methods for diagnosis are obtained persistently negative results. The optimal duration of treatment has not been established, but it is recommended to adhere to the therapeutic regimen for at least two years.
Child transmission of leprosy disease does not occur in utero, but only when in contact with the mother. To avoid infecting the newborn, it must be isolated from the mother immediately after birth.
Particular care should be evaluated individuals who were in contact with leprosy patients for a long time. The closest relatives of the patient needs to be done leprominovuyu sample. In areas where outbreaks have been identified, it is necessary to hold mass vaccination of BCG TB vaccine. TB patients should be isolated in the hospital for a rational therapy.