Related articles: Leprosy
Definition
Leprosy is a chronic infectious disease caused by Mycobacterium leprae . The transmission of this pathogen occurs through the close and prolonged contact with infected individuals, even if the mechanism is not yet completely clear. It is believed that the infection can be favored by the aerial diffusion of droplets of saliva and nasal secretions coming from sick subjects. It should be pointed out, however, that most of the people exposed and infected with M. leprae do not develop the disease, since their immune response is adequate to fight the infectious agent. Although not highly contagious and can be effectively treated with antibiotics and other therapeutic protocols, leprosy always causes anxiety.
Most common symptoms and signs *
- Alopecia
- Asthenia
- Muscular atrophy and paralysis
- Dry mouth
- Cachexia
- dactylitis
- Erectile dysfunction
- Edema
- Erythema
- Temperature
- Tingling in the legs
- Fotofobia
- Gynecomastia
- hypercalcemia
- Hypoaesthesia
- hypohidrosis
- macules
- Closed nose
- papules
- Nosebleeds
- Nephrotic syndrome
- Skin Ulcers
Further indications
Mycobacterium leprae has a tropism for peripheral nerves, the skin and mucous membranes (especially those of the upper respiratory tract and eyes). The etiological agent multiplies very slowly and the symptoms can take from 6 months to several years before appearing. Furthermore, there are different forms of leprosy, given that the nature and severity of the disease depend on the type of immune response activated in the host organism following infection.
After the incubation period, leprosy begins with a first skin lesion, which is usually "indeterminate": it causes one or a few lighter spots than normal skin color (hypopigmented) or erythematous (reddish), before to evolve into the tubercoloid, lepromatous or borderline form (ie with intermediate characteristics). The cutaneous manifestations present a characteristic hypoesthesia (loss of sensitivity).
Over time, the skin lesions can be particularly disfiguring on the face, as they thicken the skin on the forehead and cause the appearance of alopecia of eyelashes and eyebrows, in addition to deforming or destroying the auricles, the septum and the nasal bones. The involvement of the peripheral nervous system causes a feeling of numbness, weakness and lack of sensitivity to touch, heat or pain in the extremities (hands, arms, feet and legs) in the areas controlled by the affected nerves.
The slow impairment of peripheral nerves causes edema and thickening; sensory hypofunction, in turn, causes ulcerations that become complicated with infections and necrosis, to the extent that extremity amputations are required. The evolution of the disease can be associated with the onset of macules, papules and hard nodules (lepromas), which converge, leading to severe ulceration and tissue destruction. If left untreated, leprosy can cause serious and permanent damage to nerves, bones, joints, muscles, kidneys, testicles, eyes and nose.
The skeleton is directly attacked by the disease; mainly the fingers and toes are affected, in addition to the alveolar process of the maxillary bone. Other areas of the body can be affected. Damage to the nasal mucosa can result in chronic nasal congestion and nosebleeds. Eye involvement causes photophobia (light sensitivity), iritis, glaucoma and blindness. In severe cases, leprosy can also damage the kidneys, leading to chronic renal failure. In men, testicular damage can cause erectile dysfunction, gynecomastia and sterility.
Early diagnosis, confirmed by biopsy, and multi-drug therapy (MDT, multi-drug therapy) remain the key elements to solve the disease.
