Hansen’s Disease

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What is Hansen’s Disease?

Hansen’s Disease is a chronic infectious disease caused by the leprosy bacillus. It affects mainly the peripheral nerves, the skin, muscles, eyes, bones, testes, and internal organs. It is one of the oldest diseases known to mankind. The word leper comes from a Greek word. In India, it is known as “KushtaRoga” and is attributed to a punishment from God.

Southeast Asia has the highest number of leprosy cases in the whole world. It is a major public health problem in India. The prevalence of leprosy in India is 6.7 per 10000 population. The numbers of infectious cases vary between 15-20 percent. India has the highest recorded number of leprosy patients in the whole world.

Spread of infections via nasal discharge either by blowing the nose or sneezing in public. Leprosy cases harbor millions of leprosy bacilli in their nasal mucosa. Leprosy is a social disease. It is common amongst the poor due to overcrowding, poor housing and lack of hygiene. It can spread by close contact as well as from person to person and skin to skin contact. Leprosy has an incubation period of 3-5 years.

Types of Leprosy

1. Indeterminate type:

This denotes early cases with one or two vague hypopigmented patches with definite sensory impairment. Common on knees and elbows.

2. Tuberculoid type:

This type denotes those cases with one or two well-defined lesions which may be flat or raised, hypopigmented or reddish, and with no sensations.

3. Borderline type:

There are four or more lesions that may be flat or raised, well or ill-defined, hypopigmented or reddish with no sensations.

4. Lepromatus type:

There is diffuse infiltration or numerous flat or raised, poorly defined,
shiny, smooth, symmetrically distributed lesions. The lesions are bacteriologically positive.

5. Pure neurotic type:

There is only nerve involvement. There are no skin lesions.

Management of Hansen’s Disease

1. Consult a doctor immediately.
2. Treatment with anti-leprosy drugs is a prolonged one.

Deformities in Leprosy

1. Face:

Mask face, face Leonia, sagging face, loss of eyebrow and eyelashes, corneal ulcers of the eyes, perforated nose. Depressed nose, ear deformities.

2. Hands:

Claw hands, wrist drop, ulcers, absorption of fingers, thumb web contractions, swollen hands.

3. Feet:

Ulcers, foot drop, inversion of the feet, clawing of toes, absorption of toes, collapsed foot, swollen foot, callosities.

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