Leprosy: a primer for Canadian physicians

January 2004
CMAJ: Canadian Medical Association Journal;1/6/2004, Vol. 170 Issue 1, p71
Academic Journal
LEPROSY IS A RARE BUT SERIOUS INFECTIOUS DISEASE caused by My-cobacterium leprae. While global prevalence of the disease is decreasing, increasing rates of immigration from countries where leprosy is endemic have led to the recognition of this ill-ness in North America. Classically, leprosy presents as hypopig-mented cutaneous macules along with sensory and motor pe-ripheral neuropathies, although the clinical manifestations vary along a disease spectrum. In addition to primary infection, pa-tients may undergo a "reaction," an acute inflammatory re-sponse to the mycobacterium, which leads to pain and ery-thema of skin lesions and dangerous neuritis. Reactions can occur at any time during the course of leprosy, but they tend to be precipitated by treatment. They are a significant cause of im-paired quality of life due to marked nerve damage and thus war-rant prompt intervention. Although leprosy may have a pro-tracted onset and be difficult to recognize, cure is achievable with appropriate multidrug therapy. Because untreated leprosy can result in permanent, irreversible nerve damage and sec-ondary transmission, early diagnosis and treatment are essential to minimize morbidity.


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