eMedicine Specialties > Infectious Diseases > Skin and Soft-Tissue Infections

Leprosy: Multimedia

Author: D Scott Smith, MD, MSc, DTM&H, Adjunct Assistant Professor, Department of Microbiology and Immunology, Stanford University; Chief of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, Kaiser Redwood City Hospital
Coauthor(s): Tara Ramachandra, Stanford University School of Medicine
Contributor Information and Disclosures

Updated: Aug 19, 2008

Multimedia

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Media file 1: Hands with Z-thumbs, clawing, contractures, and shortening of fingers due to repetitive injury and healing. Ho Chi Minh City, Vietnam. (Courtesy of D. Scott Smith, MD)

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Hands with Z-thumbs, clawing, contractures, and shortening of fingers due to repetitive injury and healing. Ho Chi Minh City, Vietnam. (Courtesy of D. Scott Smith, MD)

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Media file 2: Patient with facial nerve palsy and contractures of the hand. Daloa, Ivory Coast. (Courtesy of D. Scott Smith, MD)

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Patient with facial nerve palsy and contractures of the hand. Daloa, Ivory Coast. (Courtesy of D. Scott Smith, MD)

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Media file 3: Chronic insensate patch due to leprosy infection. Ho Chi Minh City, Vietnam. (Courtesy of D. Scott Smith, MD)

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Chronic insensate patch due to leprosy infection. Ho Chi Minh City, Vietnam. (Courtesy of D. Scott Smith, MD)

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Media file 4: Characteristic clawed hand deformity caused by ulnar involvement in leprosy. Daloa, Ivory Coast. (Courtesy of D. Scott Smith, MD)

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Characteristic clawed hand deformity caused by ulnar involvement in leprosy. Daloa, Ivory Coast. (Courtesy of D. Scott Smith, MD)

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Media file 5: Chronic nonhealing ulcer at the metatarsal head resulting from loss of sensation in the feet. Karigiri, Tamil Nadu, India. (Courtesy of Tara Ramachandra)

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Chronic nonhealing ulcer at the metatarsal head resulting from loss of sensation in the feet. Karigiri, Tamil Nadu, India. (Courtesy of Tara Ramachandra)

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Media file 6: Multiple flat hypopigmented lesions on shoulder and neck, suggestive of multibacillary leprosy. Note ulceration of hypothenar area of hand, indicative of ulnar neuropathy. Redwood City, California, United States. (Courtesy of D. Scott Smith, MD)

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Multiple flat hypopigmented lesions on shoulder and neck, suggestive of multibacillary leprosy. Note ulceration of hypothenar area of hand, indicative of ulnar neuropathy. Redwood City, California, United States. (Courtesy of D. Scott Smith, MD)

(Enlarge Image)

Media file 7: Man with advanced deformities caused by unmanaged leprosy. Keratitis, loss of eyebrow, thickened skin, and typical hand impairments. Ho Chi Minh City, Vietnam. (Courtesy of D. Scott Smith, MD)

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Man with advanced deformities caused by unmanaged leprosy. Keratitis, loss of eyebrow, thickened skin, and typical hand impairments. Ho Chi Minh City, Vietnam. (Courtesy of D. Scott Smith, MD)

(Enlarge Image)

Media file 8: Histopathology of leprosy: Large numbers of acid-fast bacilli (in clusters) in histiocytes and within nerves. Fite-Faraco stain 500 X. (Courtesy of Tara Ramachandra and D. Scott Smith, MD)

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Histopathology of leprosy: Large numbers of acid-fast bacilli (in clusters) in histiocytes and within nerves. Fite-Faraco stain 500 X. (Courtesy of Tara Ramachandra and D. Scott Smith, MD)

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Media file 9: Patient with multibacillary leprosy showing subsequent erythema nodosum leprosum reaction. Santa Clara, California. (Courtesy of D. Scott Smith, MD)

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Patient with multibacillary leprosy showing subsequent erythema nodosum leprosum reaction. Santa Clara, California. (Courtesy of D. Scott Smith, MD)

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Media file 10: Patient with erythema nodosum leprosum type 2 reaction several weeks after initiation of drug therapy. This photograph was taken after tendon release. Redwood City, California. (Courtesy of D. Scott Smith, MD)

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Patient with erythema nodosum leprosum type 2 reaction several weeks after initiation of drug therapy. This photograph was taken after tendon release. Redwood City, California. (Courtesy of D. Scott Smith, MD)

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Media file 11: Increased pigmentation on the face due to clofazimine therapy. (Courtesy of D. Scott Smith, MD)

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Increased pigmentation on the face due to clofazimine therapy. (Courtesy of D. Scott Smith, MD)

More on Leprosy

Overview: Leprosy

Differential Diagnoses & Workup: Leprosy

Treatment & Medication: Leprosy

Follow-up: Leprosy

Multimedia: Leprosy

References

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References

World Health Organization. Global leprosy situation, 2005. Wkly Epidemiol Rec. Aug 26 2005;80(34):289-95. [Medline].
Scollard DM, Adams LB, Gillis TP, et al. The continuing challenges of leprosy. Clin Microbiol Rev. Apr 2006;19(2):338-81. [Medline].
Joyce MP, Scollard DM. Leprosy (Hansen's Disease). Conn's Current Therapy. 2004;100-105.
Ustianowski AP, Lockwood DN. Leprosy: current diagnostic and treatment approaches. Curr Opin Infect Dis. Oct 2003;16(5):421-7. [Medline].
Anderson GA. The surgical management of deformities of the hand in leprosy. J Bone Joint Surg Br. Mar 2006;88(3):290-4. [Medline].
Walker SL, Lockwood DN. Leprosy. Clin Dermatol. Mar-Apr 2007;25(2):165-72. [Medline].
Anderson H, Stryjewska B, Boyanton BL, et al. Hansen disease in the United States in the 21st century: a review of the literature. Arch Pathol Lab Med. Jun 2007;131(6):982-6. [Medline].
[Best Evidence] Van Veen NH, Nicholls PG, Smith WC, Richardus JH. Corticosteroids for treating nerve damage in leprosy. Cochrane Database Syst Rev. Apr 18 2007;CD005491. [Medline].
Bakker MI, Hatta M, Kwenang A, et al. Risk factors for developing leprosy--a population-based cohort study in Indonesia. Lepr Rev. Mar 2006;77(1):48-61. [Medline].
Britton WJ, Lockwood DN. Leprosy. Lancet. Apr 10 2004;363(9416):1209-19. [Medline].
Deps PD, Guedes BV, Bucker Filho J, Andreatta MK, Marcari RS, Rodrigues LC. Characteristics of known leprosy contact in a high endemic area in Brazil. Lepr Rev. Mar 2006;77(1):34-40. [Medline].
Jacobson RR, Krahenbuhl JL, Yoder L. Overview of Leprosy. UpToDate. 2006.
Leprosy. World Health Organization. Available at www.who.org.
Moschella SL. An update on the diagnosis and treatment of leprosy. J Am Acad Dermatol. Sep 2004;51(3):417-26. [Medline].
Rao PS, Sugamaran DS, Richard J, et al. Multi-centre, double blind, randomized trial of three steroid regimens in the treatment of type-1 reactions in leprosy. Lepr Rev. Mar 2006;77(1):25-33. [Medline].
Sridharan R, Lorenzo N, Narasimhan L. Leprosy. eMedicine. 2005.
van Beers SM, Hatta M, Klatser PR. Patient contact is the major determinant in incident leprosy: implications for future control. Int J Lepr Other Mycobact Dis. Jun 1999;67(2):119-28. [Medline].

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Keywords

leprosy, Hansen's disease, Hansen disease, Mycobacterium leprae, M leprae, tuberculoid leprosy, TT leprosy, lepromatous leprosy, LL leprosy, BT leprosy, midborderline leprosy, BB leprosy, borderline lepromatous leprosy, BL leprosy, paucibacillary leprosy, PB leprosy, multibacillary leprosy, MB leprosy, indeterminate leprosy, borderline leprosy

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Contributor Information and Disclosures

Author

D Scott Smith, MD, MSc, DTM&H, Adjunct Assistant Professor, Department of Microbiology and Immunology, Stanford University; Chief of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, Kaiser Redwood City Hospital
D Scott Smith, MD, MSc, DTM&H is a member of the following medical societies: American Medical Association, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, and International Society of Travel Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Tara Ramachandra, Stanford University School of Medicine
Disclosure: Nothing to disclose.

Medical Editor

Fred A Lopez, MD, Associate Professor and Vice Chair, Department of Medicine, Assistant Dean for Student Affairs, Louisiana State University School of Medicine
Fred A Lopez, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, Infectious Diseases Society of America, and Louisiana State Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Charles V Sanders, MD, Edgar Hull Professor and Chairman, Department of Internal Medicine, Professor of Microbiology, Immunology and Parasitology, Louisiana State University School of Medicine at New Orleans; Medical Director, Medicine Hospital Center, Charity Hospital and Medical Center of Louisiana at New Orleans; Consulting Staff, Ochsner Medical Center
Charles V Sanders, MD is a member of the following medical societies: Alliance for the Prudent Use of Antibiotics, Alpha Omega Alpha, American Association for the Advancement of Science, American Association of University Professors, American Clinical and Climatological Association, American College of Physician Executives, American College of Physicians, American Federation for Medical Research, American Foundation for AIDS Research, American Geriatrics Society, American Lung Association, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Association for Professionals in Infection Control and Epidemiology, Association of American Medical Colleges, Association of American Physicians, Association of Professors of Medicine, Infectious Disease Society for Obstetrics and Gynecology, Infectious Diseases Society of America, Louisiana State Medical Society, Orleans Parish Medical Society, Royal Society of Medicine, Sigma Xi, Society of General Internal Medicine, Southeastern Clinical Club, Southern Medical Association, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

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eMedicine Specialties > Infectious Diseases > Skin and Soft-Tissue Infections

Leprosy: Multimedia

Multimedia

Hands with Z-thumbs, clawing, contractures, and shortening of fingers due to repetitive injury and healing. Ho Chi Minh City, Vietnam. (Courtesy of D. Scott Smith, MD)

Patient with facial nerve palsy and contractures of the hand. Daloa, Ivory Coast. (Courtesy of D. Scott Smith, MD)

Chronic insensate patch due to leprosy infection. Ho Chi Minh City, Vietnam. (Courtesy of D. Scott Smith, MD)

Characteristic clawed hand deformity caused by ulnar involvement in leprosy. Daloa, Ivory Coast. (Courtesy of D. Scott Smith, MD)

Chronic nonhealing ulcer at the metatarsal head resulting from loss of sensation in the feet. Karigiri, Tamil Nadu, India. (Courtesy of Tara Ramachandra)

Multiple flat hypopigmented lesions on shoulder and neck, suggestive of multibacillary leprosy. Note ulceration of hypothenar area of hand, indicative of ulnar neuropathy. Redwood City, California, United States. (Courtesy of D. Scott Smith, MD)

Man with advanced deformities caused by unmanaged leprosy. Keratitis, loss of eyebrow, thickened skin, and typical hand impairments. Ho Chi Minh City, Vietnam. (Courtesy of D. Scott Smith, MD)

Histopathology of leprosy: Large numbers of acid-fast bacilli (in clusters) in histiocytes and within nerves. Fite-Faraco stain 500 X. (Courtesy of Tara Ramachandra and D. Scott Smith, MD)

Patient with multibacillary leprosy showing subsequent erythema nodosum leprosum reaction. Santa Clara, California. (Courtesy of D. Scott Smith, MD)

Patient with erythema nodosum leprosum type 2 reaction several weeks after initiation of drug therapy. This photograph was taken after tendon release. Redwood City, California. (Courtesy of D. Scott Smith, MD)

Increased pigmentation on the face due to clofazimine therapy. (Courtesy of D. Scott Smith, MD)

More on Leprosy

References

Further Reading

Keywords

Contributor Information and Disclosures

Author

Coauthor(s)

Medical Editor

Pharmacy Editor

Managing Editor

CME Editor

Chief Editor