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Leprosy is an infectious disease that has been known since biblical times. It is characterized by disfiguring skin sores, nerve damage, and progressive debilitation.

Leprosy is caused by the organism Mycobacterium leprae. It is not very contagious (difficult to transmit) and has a long incubation period (time before symptoms appear), which makes it difficult to determine where or when the disease was contracted. Children are more susceptible than adults to contracting the disease.

Leprosy has two common forms, tuberculoid and lepromatous, and these have been further subdivided. Both forms produce sores on the skin, but the lepromatous form is most severe, producing large, disfiguring nodules (lumps and bumps).

All forms of the disease eventually cause peripheral neurological damage (nerve damage in the arms and legs) which causes sensory loss in the skin and muscle weakness. People with long-term leprosy may lose the use of their hands or feet due to repeated injury resulting from lack of sensation.

Leprosy is common in many countries worldwide, and in temperate, tropical, and subtropical climates. Approximately 100 cases per year are diagnosed in the United States. Most cases are limited to the South, California, Hawaii, and U.S. island possessions.

Effective medications exist, and isolation of victims in "leper colonies" is unnecessary. The emergence of drug-resistant Mycobacterium leprae, as well as increased numbers of cases worldwide, have led to global concern about this disease.

Symptoms include:

• Skin lesions that are lighter than your normal skin color
  • Lesions have decreased sensation to touch, heat, or pain
  • Lesions do not heal after several weeks to months
• Numbness or absent sensation in the hands, arms, feet, and legs
• Muscle weakness

• Lepromin skin test can be used to distinguish lepromatous from tuberculoid leprosy, but is not used for diagnosis.
• Skin scraping examination for acid fast bacteria

A number of different antibiotics are used to kill the bacteria that causes the disease.

Aspirin, prednisone, or thalidomide are used to control inflammation.

Early recognition is important. Early treatment limits damage by the disease, renders the person noninfectious, and allows for a normal lifestyle.

• Permanent nerve damage
• Cosmetic disfigurement

Call your health care provider if signs or symptoms described here occur, especially following exposure. Cases of leprosy in the United States need to be reported to the Centers for Disease Control and Prevention.

Prevention consists of avoiding close physical contact with untreated people. People on long-term medication become noninfectious (they do not transmit the organism that causes the disease).

Hansen's disease

Updated by: Kenneth M. Wener, MD, Department of Infectious Diseases. Lahey Clinic, Burlington, MA. Review provided by VeriMed Healthcare Network.