Leprosy (Mycobacterium leprae)
Any person with the following clinical picture: leprosy is a chronic bacterial disease characterised by the involvement primarily of skin as well as peripheral nerves and the mucosa of the upper airways. Clinical forms of leprosy represent a spectrum reflecting the cellular immune response to Mycobacterium leprae. The clinical manifestations of the disease vary in a continuous spectrum between the two polar forms, lepromatous and tuberculoid leprosy:
- In lepromatous (multibacillary) leprosy, nodules, papules, macules and diffuse infiltrations are bilateral symmetrical and usually numerous and extensive; involvement of the nasal mucosa may lead to crusting, obstructed breathing and epistaxis; ocular involvement leads to iritis and keratiti
- In tuberculoid (paucibacillary) leprosy, skin lesions are single or few, sharply demarcated, anaesthesic or hypoaesthesic, and bilateral asymmetrical; involvement of peripheral nerves tends to be severe
- Borderline leprosy has features of both polar forms and is more labile
- Indeterminate leprosy is characterised by hypopigmented macules with ill- defined borders; if untreated, it may progress to tuberculoid, borderline or lepromatous disease
At least one of the following two:
- Demonstration of characteristic acid-fast bacilli in skin or dermal nerve, obtained from either a punch biopsy or a slit skin biopsy of a lepromatous lesion (depending on the clinical presentation). The identity of Mycobacterium leprae can be confirmed by nucleic acid amplification tests.
- Histopathological report from skin or nerve biopsy compatible with leprosy (Hansen’s disease) examined by a consultant pathologist experienced in leprosy diagnosis.
A. Possible case
B. Probable case
C. Confirmed case
Any person meeting the clinical and the laboratory criteria
Current as of: 28 May 2018