Types of Innate Immunity

Innate immunity can be divided into following types: Species immunity: Individuals of same species show uniform pattern of susceptibility to different bacterial infection. The mechanism of species immunity may be due to physiological and biochemical differences between tissue of host species which determine whether or not pathogen can multiply in them e.g., poliomyelitis, measles, syphilis, […]

Treatment of Paucibacillary types (TT, BT and I)

Short course chemotherapy with Dapsone and Rifampicin is suggested. Dose:- 1. Dapsone 100 mg (1-2 mg kg body weight) daily for 6 months, 2. Rifampicin 600 mg once a month for 6 months
Indications:- 1. All newly diagnosed paucibacillary types of cases. 2. All dapsone treated patients who have relapsed. 3. Those who are currently on […]

Multi Drug Therapy for Leprosy

A. MalanMary Types (LL, BL & BB): Objectives : - 1. To interrupt transmission of infection. 2. To cure the patient. The only way to prevent the spread of the dapsone resistant leprosy is to use Multi Drug Therapy. (MDT)
MDT is proposed for all category of multibacillary patients including:
a) Freshly diagnosed, previously untreated cases
b) who […]

Dapsone Resistance

Resistance of Mycobacterium leprae to dapsone should be suspected when a patient fails to improve or deteriorates during supervised treatment with the drug. Dapsone resistance may be confirmed by inoculating mice with M. leprae recovered from the patient and then treating the mice with dapsone to determine whether the drug is capable of preventing multiplication […]

Histopathology of Leprosy

1 TT Type: Well formed tubercles are seen in the upper and mid dermis. Each tubercle consists of centrally collected epithe loid cells and Langhan’s type of giant cells and peripheral dense ring of lymphocytes. The granuloma in most cases invade the base of epidermis. Sometimes massive enlargement of nerve bundle is seen which may […]

Prevention and Control of Leprosy

Leprosy is a chronic infectious and communicable disease. Many of patients with leprosy are having infectious (bacilliferous) type of the disease. This is the main source of infection. Seggregation of leprosy patients voluntarily or forcibly is one of the steps in control of the. disease. But it is a great task and often leads to […]

Chemotherapy of Leprosy

Recently WHO study group met at Geneva in October 1981 recommended the following regimen of chemotherapy of leprosy in control programmes.
The four main drugs they recommended for combined therapy are:

Dapsone
Rifampicin
Clofazimine
Ethionamide prothionamide

Use of only one drug can increase the risk of multiple resistance: So they recommended that at least two additional drugs should be combined with […]

Treatment of bacilliferous and paucibacillary leprosy:-

Treatment of bacilliferous types of leprosy:- 1) Dapsone 1-2 mg / kgm body weight daily to be continued life long and Rifampicin 600 mg daily (450 mg for those who weigh 35 kg) for a minimum period of three weeks. OR 2) Dapsone 1-2 mg […]

Lepromin test

MI is the percentage of live bacilli. The solidly stained organisms are considered as live bacilli, whereas the beaded or granular forms are dead organisms. To find out MI in a smear, count 100 bacilli in the smear and record the number of solidly stained ones among this 100. It is the MI and reported […]

Classification of Leprosy

Clinically there are 6 types of leprosy. They are:

Indeterminate (I)
Tuberculoid (TT)
Borderline Tuberculoid. (BT)
Borderline Borderline (mid Borderline) (BB)
Borderline lepromatous (BL)
Lepromatous (LL)

Indeterminate leprosy:- These are the early lesions of leprosy and present as a single or rarely multiple hypopigrnented, Hide-fined macules. Anaesthesia and analgesia may be noted […]

Treatment of Lepra Reaction

Mild reactions can be controlled with analgesics like c tyl salicylic acid and antiinflammatory drugs like chioroquin. Chloroquin is usually given in a dose of 200 mg tid for 10 days and then the dose can be reduced gradually. Clofazimine, in addition to its antimycobacterial action, has pronounced anti-inflammatory action also which is made use […]

Leprosy (Hansen’s disease)

Leprosy (Hansen’s disease) is a chronic infectious disease caused by an acid fast bacillus called Mycobacterium leprae. These organisms are seen in clumps in tissue smears and are less acid fast and less alcohol fast than mycobacterium tuberculosis, the causative organism for tuberculosis. In vitro culture of the organism is still not successful; even though […]

Problem of Dapsone Resistance

Dapsone is in use in leprosy since 1941. Erickson in 1950 first reported clinical relapse in a case treated with dapsone. In 1964 Petit etal proved mycobacterial resistance to dapsone experimentally. Different causes attributed to dapsone resistance are (1) Prolonged treatment with a singIe drug (2) Irregular and inadequate intake of the drug by patients […]

Intralesion Steroid Therapy

Micronised suspensions of hydrocortisone acetate or triam. cinolone acetnuide can be used for intralesion therapy. They are injected into the skin lesion with a needle. Injection of the drug at multiple sites in the lesion can be done with the help of a dermojet also.
The drug is relatively insoluble and remains in the skin for […]