LEPROSY

Question 1

__ a chronic granulomatous disease affecting mainly the skin and nerves caused by the obligate intracellular pathogen __

Answer 1

LEPROSY

Mycobacterium leprae

Question 2

Leprosy primarily involves the ____

Answer 2

skin and nerves

Question 3

Leprosy diagnosis:
Based on clinical signs and symptoms, hallmarks
include:
1.
2.
3.

Answer 3

loss of sensation within skin lesions,

nerve swelling or pain, or

demonstration of acid-fast bacilli in skin smears or biopsies

Question 4

More than 80% of all new cases are detected in only 3 countries __

Answer 4

India, Brazil, and Indonesia

I B I

Question 5

a chronic granulomatous infection caused by
Mycobacterium leprae.

Answer 5

Leprosy

Question 6

It infects mucous cutaneous tissues and peripheral
nerves, leading to loss of sensation on the skin—with or
without dermatologic lesions—and the development of
incapacities during the progression of the disease

Answer 6

Lerosy

Question 7

one of the oldest diseases known to afflict
mankind.

Answer 7

Leprosy

Question 8

A Norwegian physician, first to describe M. leprae

Answer 8

GERHARD ARMAUER HANSEN

Question 9

Leprosy is a.k.a

Answer 9

Hansen disease.

Question 10

Single nucleotide polymorphisms (SNPs) 4 types and 16 subtypes:

Answer 10

o SNP Type 1: in Southeast Asia
▪ 4 Subtypes: A to D
o SNP Type 2: in East Africa
▪ 4 Subtypes: E to H
o SNP Type 3: in European/North African region
▪ 5 Subtypes: I to M
o SNP Type 4: in West Africa
▪ 3 Subtypes: N to P

Question 10

For decades, treatment of leprosy was done continuously with __

Answer 10

dapsone alone (monotherapy)

Question 12

Causative agent of lepros

Answer 12

MYCOBACTERIUM LEPRAE

Question 13

incubation period of

Answer 13

3-7 years

Question 14

host genes:

Answer 14

o Toll-like receptors (TLR)
o Nucleotide-binding oligomerization domain
containing 2 (NOD2)
o Mannose receptor C-type 1 lectin (MRC1) →
modulate autophagy.

Question 15

GENETIC RISK FACTORS

Answer 15

Human leukocyte antigen (HLA) complex genes (class I & II))

Question 16

Shared genetic background between leprosy and a number
of inflammatory diseases including:
o Crohn disease (NOD2)
o MI (lymphotoxin α)
o Type 1 diabetes and psoriasis (vit D receptor)
o Parkinson disease (E3 ubiquitin-protein ligase
[PARK2])

Question 17

may last for months or years before moving to spontaneous
cure or toward one of the poles or borderline forms of the clinical spectrum

Answer 17

INDETERMINATE LEPROSY

Question 18

• better cell-mediated immunity.
• With well-defined plaques

Answer 18

POLAR TUBERCULOID LEPROSY

Question 19

A special self-healing type of tuberculoid leprosy.

Answer 19

INFANTILE NODULAR LEPROSY

Question 20

POLAR LEPROMATOUS LEPROSY

Answer 20

gives the appearance of a lion’s face, known
as leonine facies

Question 21

complete lack of cell-mediated immunity.

Answer 21

POLAR LEPROMATOUS LEPROSY

Question 22

main skin manifestation is infiltration

Answer 22

LUCIO LEPROSY

Question 23

3 BORDERLINE FORMS

Answer 23

1. Borderline-tuberculoid
2. Borderline-borderline
3. Borderline-lepromatous

Question 24

presents a clear infiltrative band around the periphery of the lesions

Answer 24

BORDERLINE-TUBERCULOID

Question 25

has classical foveolar lesions

Answer 25

BORDERLINE-BORDERLINE

Question 26

Foveolar and nodular infiltrated lesions

Answer 26

BORDERLINE-LEPROMATOUS

Question 27

dryness of the skin and
alopecia restricted to the territory of the lesions.

Answer 27

Tuberculoid leprosy

Question 28

frequent symptom associated with leprosy
cases

Answer 28

Paresthesia

Question 29

Triple Lewis response

Answer 29

o Within 5 to 10 seconds → erythema will result from the
direct action of histamine on the capillaries, causing
vasodilation in both areas, normal and lesional.
o After 2 minutes → a secondary erythema caused by
capillary dilation will occur only on normal skin.
o Last phase → exudation of liquid to the dermis,
resulting in wheal formation in both areas.

Question 30

IODINE-STARCH OR ALIZARIN RED:

Findings:
o Normal skin →

o Leprosy lesions →

Answer 30

Findings:
o Normal skin → bluish or dark brown (iodine-starch) or violet (alizarin red)
o Leprosy lesions → no reaction (anhidrosis) or irregular sweating (hypohidrosis).

Question 31

Loss of sensation via Semmes-Weinstein monofilaments
indicators:

__ → indicates diminished sensation of light touch
(0.16-0.4 g),

___ → indicates diminished protective sensation
(0.6-2 g), and

____ → indicates more profound loss of protective
sensation (4-300 g).

Answer 31

Loss of sensation via Semmes-Weinstein monofilaments
indicators:
o Blue → indicates diminished sensation of light touch
(0.16-0.4 g),
o Purple → indicates diminished protective sensation
(0.6-2 g), and
o Red → indicates more profound loss of protective
sensation (4-300 g).

Question 32

divides the disease into 5 forms based on the number of acid-
fast bacilli and the degree of lymphocytic infiltration and organization

Answer 32

RIDLEY-JOPLING CLASSIFICATION SYSTEM