Diagnosis and Treatment
In the United States, most physicians do not have experience identifying leprosy because it is extremely rare (about 100-200 new cases per year, mostly occurring in the Gulf Coast, Hawaii, Massachusetts, and New York and among individuals who have lived in areas of the world where the disease is more widespread). It is important that people who have unusual rashes that do not respond to treatment seek out skilled dermatologists who can make an accurate diagnosis.
Diagnosis of leprosy is typically based on clinical symptoms, especially localized skin lesions that show sensory loss (loss of sensation to stimuli such as touch and heat). Thickened, enlarged peripheral nerves are also a hallmark of the disease. Skin and blood samples can also be tested in order to reach a conclusive diagnosis.
With early diagnosis, leprosy can be treated. People who are getting treatment for leprosy are not contagious, and they can lead a normal lifestyle.
In 1981, the World Health Organization (WHO) recommended multidrug therapy (MDT) with dapsone, rifampicin, and clofazimine. The regimen for multibacillary is monthly for a period of one year and for paucibacillary it is monthly doses of rifampicin and daily doses of dapsone for a period of six months. Although several groups are now advocating uniform treatment for all forms of leprosy; this is being debated in the scientific community.
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