Teaching bangsal I

By:Khairun Liyana Mat ShahMuhammad HaekalPriska Kurnia Perdana

LEPROSY

Leprosy was said to origin from Africa or Middle Asia and was then spreading To the world through the act of war, penjajahan, perdagangan etc.

The bacteria was first discovered by Dr. Gerhard Armauwer Hansen on 1874.The disease then being called as Morbus Hansen, taking from the name of Dr. Hansen.

This disease was said to come to Indonesia in 4th or 5th century by Indian men.

The word KUSTA was originally taken from sanskrit,KUSHTHA a group of skin syndrom

HISTORY AT A GLANCE

DEFINITION:

Leprosy is a chronic granulomatous infectiondisease cause by Mycobacterium leprae (M. Leprae), attacking peripheral nerve and skin.

The bacteria would spread toother people by:

Direct skin contactIndirect skin contactGenetic

Diagnosis:

1. Cardinal sign

Hipostesi / anasthesy - sensation test : touch, pain, temp.b) Nerve enlargement - palpate the nerves involvec) BTA positive - gold standard - slit skin smear

CLINICAL PRESENTATION / DIAGNOSIS

Classification of Leprosy:

Ridley and joppling

a. Intermediate - Few numbers of hypopigmented macules (cutaneous lesions) may occur. Loss of sensation is rare.

b. Tuberculoid Tuberculoid - stable, hipopigmented, erythematous, elevated, scaling, sensory nerve may not be enlarged

c. Borderline Tuberculoid -unstable, plaques and papules, satellites

d. Borderline Borderline -plaques,erythematous, irregular, hypoanesthesy, nerve enlargement (+)

e. Borderline Lepromatous -lession symmetris, papule, plaques,nodules, snesthesia is often absent.

f. Lepromatous Lepromatous -100% lepromatous, stable, symmetric, spreading all over the body, varnished appearence

2. WHO

PAUCIBACILLARMULTIBACILLARTT,BTBB,BL,LLLepromatos lession < 5Lepromatous lession > 51 nerve enlargement>1 nerve enlargementBTA (-)BTA (+)

ANTIGEN-ANTIBODY REACTION IN LEPROSY

Definition:

A phase for leprosy disease with a manifestionof hipersensitivation (redness or pain) appear before,during or after treatment which might be due toantigen-antibody reaction.

Type 1 reaction ReversibleCellular immune system increase rapidly Active skin lessionNerve inflamationFever

Type 2 reaction ENLHumoral reactionMild: nodules with painSevere: ulceration, nerve dysfunction, other organs inflamation (+)

Differential diagnosis

Vitiligo Dermatitis seborrheic

Psoriasis

TREATMENT

PB - Dapson 100mg daily Rifampicin 600mg / month

MB Dapson 100mg/day Rifampicin 600mg / month Lamprene 50mg / day

Leprosy antigen-antibody reaction: corticosteroid, prednisolone

Thank You