CPG Flashcards
Leprosy is considered based on how many of the 3 cardinal signs?
only 1
What are the 3 cardinal signs of leprosy?
- Definite loss of sensation in a pale (hypopigmented) or reddish skin patch
- Thickened or enlarged peripheral nerve + loss of sensation and/or weakness of the muscles supplied by that nerve (with associated sensory and motor deficits)
- Presence of acid fast bacilli in a slit skin smear
what is the medical term for loss of sensation?
hypoesthesia
what is an ideal tool for testing for hypoesthesia?
a graded monofilament
what are the 2 most commonly affected nerves in leprosy?
ulnar nerve and the peroneal nerve
*but any peripheral nerve may be involved
What are the signs of nerve damage?
numbness, tingling or muscle weakness
Does a negative slit skin smear rule out leprosy?
NO
*unless the other cardinal signs are also absent
What does a positive slit skin smear indicate?
A positive slit skin smear indicates that the patient has multibacillary leprosy
The slit- skin smear requires an expert in this procedure that may not be available in the primary care settings
The slit- skin smear requires an expert in this procedure that may not be available in the primary care settings
When a diagnosis of leprosy can be definitively made based only on clinical signs, a slit-skin smear or a histopathological examination is no longer necessary. However, it is recommended that in settings where SSS are available, this histopathological test may be obtained to complement the initial clinical diagnosis.
Determining the pre-treatment bacillary index is also helpful for monitoring?
1) the patient
2) identifying treatment failure or resistance to MDT treatment
The consensus panel also acknowledges the high sensitivity and specificity of serological tests for leprosy. However, facilities and equipment in primary care settings considered, these tests may not be widely availble.
ELISA, conventional PCR, Lateral flow, Agglutination
