Numbness on skin spots, loss of feeling in the hands and feet, and muscle weakness are all symptoms of peripheral nerve loss. Leprosy symptoms vary depending on how far the disease has progressed. If you suspect that you may have leprosy and you are in the United States, know that your dermatologist or general practitioner may not have leprosy top-of-mind during the examination process, since the disease is so rare in this country.
Physicians in the United States are likely unfamiliar with leprosy symptoms. Next, to confirm a diagnosis of leprosy, a skin or nerve biopsy is performed. For the skin biopsy, a sample is taken from the edges of skin patches to be further examined under a microscope.
And for the nerve biopsy, a small piece of material is extracted from a thickened peripheral nerve to be more closely examined. Leprosy occurs on a continuum: Some cases are mild, afflicting a few areas of skin, while others are more severe, affecting many skin areas and causing damage to nerves and organs that can lead to disfigurement.
While some physicians and researchers use a more complex system to define and categorize various forms of leprosy, most use the following two-pronged, more simplified classification. Paucibacillary leprosy PB This classification, which includes indeterminate, tuberculoid, and borderline tuberculoid leprosy, is based on a negative skin smear, meaning patients have relatively few bacteria in the skin and nerves.
With PB leprosy, individuals most likely have five or fewer affected skin areas, 8 although sometimes there are more. Multibacillary leprosy MB Individuals in this category have a large number of bacteria present in their skin and nerves, and their symptoms are more widespread.
With oral antibiotics and prompt treatment, leprosy is curable. In fact, most individuals diagnosed with leprosy in the United States have little or no disability upon diagnosis. In addition, the majority of people with leprosy are able to carry on with normal activities during treatment with little interruption. If recent nerve damage is present at diagnosis, prompt treatment may be able to improve the damage or stave off further issues. If significant nerve damage occurs, a long-term management plan involving a variety of healthcare professionals, such as physicians, an occupational therapist, physical therapist, ophthalmologist , and podiatrist, can help prevent disability.
Some ways this can be achieved include:. Once treatment begins, it usually takes one to two years to be completely rid of the disease.
That said, nerve damage or physical disfiguration that occurs as a result of leprosy cannot be reversed. Leprosy is a highly treatable — and even curable — disease, especially when diagnosed early before any permanent nerve damage has occurred.
Leprosy should be combated with a combination of three drugs, consisting of rifampin Rifadin or Rimactane , dapsone Aczone , and clofazimine Lamprene. After just a few doses — which are generally given at home — individuals become noninfectious. Treatment for paucibacillary leprosy should last six months; treatment for multibacillary leprosy should extend to 12 months. For those who are resistant to the above meds, alternatives like clarithromycin , minocycline , or a quinolone may be used — and treatment may take longer.
Side effects of MDT are generally mild and temporary — and serious side effects are rare. These side effects may include darkening of the skin, dry skin , or scaliness and are best treated with analgesics like acetaminophen or ibuprofen , or corticosteroids. This means that people can contract leprosy by inhaling droplets expelled through the coughing or sneezing of an infected person.
Some of these animals, which are found in the southern United States, are naturally infected with the bacteria that cause leprosy. Leprosy is not spread via sexual intercourse or casual contact, such as shaking hands or sitting next to an individual with the disease. As many as half of all those with leprosy have reactions to multidrug therapy; these reactions can include pain and swelling in the skin and nerves, fever, muscle aches, and pain and redness in the eyes. It can take years for the body to completely rid itself of all the dead bacteria.
Some people experience these reactions before multidrug therapy has even started. In those cases, the body is reacting to bacteria that its own resistance has killed. Reaction may occur on and off for a period of time, and 1 reactions can differ depending on the type of leprosy. For instance:. Some reactions can be quelled with over-the-counter medicines, such as aspirin or Tylenol acetaminophen , while others require a prescription for prednisone or thalidomide.
The skin lesions result in decreased sensation to touch, temperature, or pain. The bacterium Mycobacterium leprae causes leprosy. This usually occurs when a person with leprosy sneezes or coughs. However, close, repeated contact with an untreated person for a longer period of time can lead to contracting leprosy. The bacterium responsible for leprosy multiplies very slowly. The disease has an average incubation period the time between infection and the appearance of the first symptoms of five years , according to the World Health Organization WHO.
According to the New England Journal of Medicine , an armadillo native to the southern United States and Mexico can also carry the disease and transmit it to humans.
The first system recognizes three types of leprosy: tuberculoid, lepromatous, and borderline. WHO categorizes the disease based on the type and number of affected skin areas:. Clinical studies use the Ridley-Jopling system. It has five classifications based on severity of symptoms.
Indeterminate leprosy may resolve or progress further to one of the five forms of leprosy within the Ridley-Jopling system. Your doctor will conduct a physical exam to look for telltale signs and symptoms of the disease. Your doctor may also perform a lepromin skin test to determine the form of leprosy. People who have tuberculoid or borderline tuberculoid leprosy will experience a positive result at the injection site.
WHO developed a multidrug therapy in to cure all types of leprosy. Additionally, several antibiotics treat leprosy by killing the bacteria that causes it. These antibiotics include:. They may also want you to take an anti-inflammatory medication such as aspirin Bayer , prednisone Rayos , or thalidomide Thalomid. The treatment will last for months and possibly up to 1 to 2 years. You should never take thalidomide if you are or may become pregnant. It can produce severe birth defects.
The best way to prevent leprosy is to avoid long-term, close contact with an untreated person who has the infection. With treatment, you can prevent problems, such as the loss of feeling or blindness. These problems can only develop when someone has leprosy for a long time. Today, we also know how to reduce the risk of catching it.
One way it spreads is from person to person. Scientists have learned that to catch leprosy, a healthy person must have months of close contact with someone who has leprosy. When a healthy person repeatedly breathes in the infected droplets, this may spread the disease.
It takes a lot of exposure to catch leprosy. You can also get leprosy from an armadillo. Lived in a country where leprosy is more common, such as India, Brazil, China, Indonesia, or parts of Africa. The bacteria that cause leprosy reproduce very slowly.
You may notice the first signs in three to four years, but it can take 20 years or longer for signs to appear.
Without treatment, the bacteria that cause leprosy can continue to reproduce. In time, they can damage nerves and other parts of your body. If this happens, you may notice one or more of the following:. Eye problems, such as difficulty blinking, which may lead to dry eyes, eye sores, and eventually blindness. While antibiotics can kill the bacteria, they cannot reverse damage caused by the bacteria. Antibiotics cannot reverse the damage done to the body.
If it looks like you may have leprosy, a board-certified dermatologist will ask questions to find out if you have any risk factors. Be sure to tell your dermatologist if you have lived in another country or spent time around armadillos.
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