World Leprosy Day 2020: Let’s Beat Leprosy Together

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Leprosy is an infectious disease caused by a bacterium, known as Mycobacterium Leprae. Though it is curable, it is contagious and can spread via close contact with already infected patients. According to the WHO, in 2018, the total number of people infected newly by leprosy was 208619. With a prevalence rate of 0.2 per 100 people, the world needs to be aware of the causes and effects of leprosy. With this aim, World Leprosy Day is observed on the last Sunday of January every year.

World Leprosy Day

Mission and Vision

The purpose of observing World Leprosy Day is to raise awareness about leprosy. There is a misconception among people that leprosy is an extinct disease. However, every year, nearly 1000 new people are diagnosed with it. French humanitarian Raoul Follereau decided in 1953 to observe World Leprosy Day on the last Sunday of January as it coincided with the death anniversary of Mahatma Gandhi. The vision of this event is to conduct public educational events that will explain leprosy to the common man and teach methods to prevent the disease’s spread. Conducting rallies, marathons, screening tests, doctors’ addresses to the public, etc. are part of the anti-leprosy campaign.

Some Facts about Leprosy

  1. Leprosy is one of the oldest diseases affecting mankind, where the infected were once considered outcasts.
  2. It has been referred to as Hansen’s disease, named after the Norwegian Gerhard Henrik Armauer Hansen, who proved that this disease is not hereditary.
  3. The bacteria M Leprae resembles a rod and spreads very fast.
  4. This infectious disease affects the skin by causing sores and disfigurement, and also the peripheral nerves, especially in the arms and legs, as well as the mucous of the upper respiratory tract and eyes.

 What are the Symptoms of Leprosy?

The symptoms of leprosy include:

  1. Pale-colored skin sores
  2. Lumps
  3. Loss of feeling in the arms and legs
  4. Muscle weakness

Symptoms appear 3 to 5 years after the invasion of the M-leprae bacteria. The incubation time for the bacteria is 5 to 20 years.

What are the Forms of Leprosy?

The first skin lesion is usually the indeterminate type, which causes one or a few hypopigmented (pale) spots before evolving into the borderline, tuberculoid or lepromatous types.

Tuberculoid leprosy

Tuberculoid leprosy can be either one large red patch with well-defined raised borders or a large hypopigmented asymmetrical spot.

Lesions become dry and hairless.

Loss of sensation may occur at the site of some lesions.

Tender, thickened nerves with subsequent loss of function are common.

Spontaneous resolution may occur in a few years or it may progress to borderline or rarely lepromatous types.

Borderline tuberculoid leprosy

Borderline tuberculoid leprosy is similar to the tuberculoid type except that lesions are smaller and more numerous.

The disease may remain in this stage or convert back to tuberculoid form, or progress.

Borderline borderline leprosy

Borderline borderline leprosy is characterised by numerous, red, irregularly shaped plaques.

Sensory loss is moderate.

The disease may remain in this stage, improve or worsen.

Borderline lepromatous leprosy

Borderline lepromatous leprosy is characterised by numerous lesions of all kinds: plaques, macules, papules, and nodules. Lesions that look like inverted saucers are common.

Hair growth and sensation are usually not impaired over the lesions.

Lepromatous leprosy

Early nerve involvement in lepromatous leprosy may go unnoticed.

Numerous lesions of all kinds may appear, like plaques, macules, papules, and nodules.

Early symptoms include nasal stuffiness, discharge and bleeding, and swelling of the legs and ankles.

Left untreated, the following problems may occur in lepromatous leprosy.

  • The skin thickens over the forehead (leonine facies), eyebrows and eyelashes are lost, the nose becomes misshapen or collapses, ear lobes thicken, and upper incisor teeth fall out.
  • Eye involvement causes photophobia (light sensitivity), glaucoma and blindness.
  • The skin on the legs thickens and forms ulcers when nodules break down.
  • Testicles shrivel, causing sterility and enlarged breasts (in males).
  • Internal organ infection causes enlarged liver and lymph nodes.
  • The voice becomes hoarse due to the involvement of the larynx.
  • Slow scarring of peripheral nerves occurs, resulting in nerve thickening and sensory loss.
  • Fingers and toes become deformed due to painless repeated trauma.

Treatments and Rehabilitation

Initially, when leprosy occurred in 1940, Dapsone was the medicine that was used for treatment. But in 1960, Leprae developed resistance to this medicine and later multi-drug therapy became the ideal treatment practice for leprosy. The MDT treatment comprises of dapsone, rifampicin, and clofazimine. This treatment kills pathogens and cures patients. MDT is made available free of cost by WHO for patients who cannot afford to buy the medicine.

A lot of stigma and discrimination against people with leprosy still exist. The intention of celebrating World Leprosy Day is to eliminate the stigma and convey the message of beating leprosy together by spreading awareness about this disease.

Dr. Raghuram Reddy. D
Dr. Raghuram Reddy. D is a dermatologist Practicing in Vijay Hospital & Radiance Skin Hair Cosmetic & Laser Center, Hyderabad. He has over 7 years of experience. He completed his M.B.B.S. in 2009 from Dr. NTR University of Health Sciences & M.D. (Dermatology) in 2014 from Rajiv Gandhi University of Health Sciences. He is holding the membership of IADVL & IMA

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