Leprosy diagnostic criteria
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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 is a very variable disease, with different clinical presentations, according to the immune response provided by the host. Therefore it is important to consider the different diagnosis that may mimic leprosy's presentation, particularly due to the psychological and social impact the diagnosis of leprosy has in someone's life.
Diagnostic Criteria
Attending to the historic and social impact of leprosy in the population, a careful assessment of the patient should be made, before advancing the definitive diagnosis of leprosy. Even when suspected in the differential diagnosis, a reasonable degree of certainty is required, before communicating this to the patient.[1]
For the diagnosis of leprosy, at least one of the following signs should be present:[1]
- Confirmed loss of sensation of a hypopigmented or erythematous skin patch. At this point is also important to count the number of skin lesions, in order to classify the type of leprosy, so that adequate therapy regimen may be started.
- A thickened peripheral nerve, with concomitant loss of sensation and/or weakness of the muscles it stimulates.
- Confirmation of acid-fast bacilli in the skin smear, although most people with leprosy will have a negative smear.