Leprosy physical examination

Leprosy Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Leprosy from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Tertiary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Leprosy physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Leprosy physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Leprosy physical examination
CDC on Leprosy physical examination
Leprosy physical examination in the news
Blogs on Leprosy physical examination
Directions to Hospitals Treating Leprosy
Risk calculators and risk factors for Leprosy physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

Paucibacillary Hansen's disease is milder and characterized by one or more hypopigmented skin macules. Multibacillary Hansen's disease is associated with symmetric skin lesions, nodules, plaques, thickened dermis, and frequent involvement of the nasal mucosa resulting in nasal congestion and epistaxis.

Physical Examination

Vitals

• A fever may be present.

Skin

• Painless cuts, wounds and burns are often present, predominantly on the hands, arms, legs and feet.
• In tuberculoid leprosy (or paucibacillar in the WHO classification), larger hypopigmented or erythematous macules are often present.
• In borderline tuberculoid leprosy (or paucibacillar in the WHO classification), macules are often sharply defined with a central clearing, more numerous than the in previous category and generally located on one side of the body.
• In mid-borderline and lepromatous leprosy (or multibacillar in the WHO classification]] lesions, central area is often anesthetic.
• In borderline lepromatous leprosy, lesions are often erythematous macules and/or papules, symmetrically distributed throughout the body. Nodular lesions are often present and there may be areas of normal skin between the lesions, however, the margins of the lesions are often diffuse, instead of well-defined. Larger lesions often have an asymmetrical diffusion.
• In lepromatous leprosy, lesions are often generalized throughout the body and be of macular, papular or nodular origin. In this class of leprosy, there is often loss of body hair, particularly of the eyebrows and eyelashes as well as nodular thickening of the earlobes.
• In [[indeterminate leprosy, lesions are often hypopigmented or erythematous macules, with diminished sensation.

Cutaneous leprosy lesions on a patient's thigh.

Head

• Facial paralysis may be present.
• Lack of eyebrows and eyelashes may be present.
• Lumps are often present, predominantly on the face and earlobes.

Eyes

• Lagophthalmos is often present.
• Blindness may be present.

Nose

• Collapsed nose (saddle nose) may be present, particularly in lepromatous leprosy.
• Perforated nasal septum may be present.
• Invasion of the nasal mucous may be present, particularly in lepromatous leprosy, imitating nasal stuffiness.

Extremities

• Weakness of the hands and feet may be present.
• Claw fingers are often present.
• Foot drop is often present.

Neurologic

• Sensory loss is often present, predominantly on skin lesions and on the territories located after enlarged peripheral nerves.
• Paresthesias are often present, predominantly in the hands and feet.
• Tender and/or enlarged peripheral nerves are often present.

References

Template:WikiDoc Sources