Leprosy natural history, complications and prognosis: Difference between revisions
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* Cosmetic disfigurement with [[skin ulceration]] and [[scars]]. | * Cosmetic disfigurement with [[skin ulceration]] and [[scars]]. | ||
* Permanent [[nerve damage]], with [[sensory loss]] | * Permanent [[nerve damage]], with [[sensory loss]], [[numbness]] and pain particularly around [[skin lesions]]. | ||
* [[Muscle weakness]] and [[paralysis]] | * [[Muscle weakness]] and [[paralysis]] with predominance in the [[hands]] and [[feet]]. | ||
* [[Contractures]] | * [[Contractures]] | ||
* [[Blindness]] - | * [[Blindness]] - conditions such as [[corneal abrasion]] and [[corneal]] ulceration may occur, potentially leading to [[blindness]]. | ||
* [[Burns]] and [[trauma]] - attending to the [[loss of sensation]], following the [[nerve damage]] caused by this condition, a potential [[complication]] is the non voluntary self-inflicted [[trauma]] as a result of the absence of [[pain]]. | * [[Burns]] and [[trauma]] - attending to the [[loss of sensation]], following the [[nerve damage]] caused by this condition, a potential [[complication]] is the non voluntary self-inflicted [[trauma]] as a result of the absence of [[pain]]. | ||
| Line 27: | Line 27: | ||
* Thick and [[dry skin]] | * Thick and [[dry skin]] | ||
* Lucio phenomenon - rare but potentially fatal [[complication]], occurring predominantly in untreated lepromatous patients, as an acute [[necrotizing]] vasculopathy. It is common to observe painful irregular patches | * Lucio phenomenon - rare but potentially fatal [[complication]], occurring predominantly in untreated lepromatous patients, as an acute [[necrotizing]] vasculopathy. It is common to observe painful irregular patches that usually become pruritic, developing bullae. This phenomenon has been noted to occur predominantly in descendants from mexican populations.<ref name="Rea1977">{{cite journal|last1=Rea|first1=Thomas H.|title=Current Concepts in the Immunology of Leprosy|journal=Archives of Dermatology|volume=113|issue=3|year=1977|pages=345|issn=0003-987X|doi=10.1001/archderm.1977.01640030091017}}</ref><ref name="pmid3329658">{{cite journal| author=Sehgal VN, Srivastava G, Sharma VK| title=Contemplative immune mechanism of Lucio phenomenon and its global status. | journal=J Dermatol | year= 1987 | volume= 14 | issue= 6 | pages= 580-5 | pmid=3329658 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3329658 }} </ref> | ||
==Prognosis== | ==Prognosis== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Leprosy may lead to severe complications if not diagnosed and treated early, which will affect the prognosis.
Natural History
Complications
One to two million persons worldwide are permanently disabled as a result of leprosy.[1] The number and degree of complications will depend on how early the condition is diagnosed and treatment with multidrug therapy is started. A late diagnosis will increase the number and severity of the complications. These may include:[2][3]
- Cosmetic disfigurement with skin ulceration and scars.
- Permanent nerve damage, with sensory loss, numbness and pain particularly around skin lesions.
- Muscle weakness and paralysis with predominance in the hands and feet.
- Blindness - conditions such as corneal abrasion and corneal ulceration may occur, potentially leading to blindness.
- Burns and trauma - attending to the loss of sensation, following the nerve damage caused by this condition, a potential complication is the non voluntary self-inflicted trauma as a result of the absence of pain.
- Infection - following painless injuries, due to the nerve damage, that become infected by bacteria and complicate.
- Thick and dry skin
- Lucio phenomenon - rare but potentially fatal complication, occurring predominantly in untreated lepromatous patients, as an acute necrotizing vasculopathy. It is common to observe painful irregular patches that usually become pruritic, developing bullae. This phenomenon has been noted to occur predominantly in descendants from mexican populations.[4][5]
Prognosis
Leprosy is a curable disease when adequately treated. With early diagnosis and treatment, the damages inflicted in patients by the disease may be reduced. Therefore, early recognition and prompt treatment are essential to improve the prognosis of patients, increasing the chances of a normal lifestyle. To improve the chances of a better prognosis, physicians, particularly of endemic areas, must be aware of the early signs and symptoms of the disease and the population must be educated to avoid infection and search medical attention when such symptoms appear, thereby minimizing complications.
References
- ↑ Walker, Stephen L.; Lockwood, Dina N.J. (2007). "Leprosy". Clinics in Dermatology. 25 (2): 165–172. doi:10.1016/j.clindermatol.2006.05.012. ISSN 0738-081X.
- ↑ Daniel E, Ffytche TJ, Kempen JH, Rao PS, Diener-West M, Courtright P (2006). "Incidence of ocular complications in patients with multibacillary leprosy after completion of a 2 year course of multidrug therapy". Br J Ophthalmol. 90 (8): 949–54. doi:10.1136/bjo.2006.094870. PMC 1857220. PMID 16707521.
- ↑ "P Hansen's Disease (Leprosy)". line feed character in
|title=at position 2 (help) - ↑ Rea, Thomas H. (1977). "Current Concepts in the Immunology of Leprosy". Archives of Dermatology. 113 (3): 345. doi:10.1001/archderm.1977.01640030091017. ISSN 0003-987X.
- ↑ Sehgal VN, Srivastava G, Sharma VK (1987). "Contemplative immune mechanism of Lucio phenomenon and its global status". J Dermatol. 14 (6): 580–5. PMID 3329658.