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OS 212 DERMATOLOGY > Leprosy > Flashcards

Leprosy Flashcards

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Dermatology Board Prep flashcards
1
Q

Chronic infection of nerves with skin manifestation

A

Leprosy

also known as Hansen’s disease

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2
Q

According to WHO, the following groups are considered to have cases of leprosy

A

Persons having one or more of the following:

Hypopigmented or reddish skin lesions with loss of sensation

Involvement of peripheral nerves

Skin smear positive for acid fast bacilli

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3
Q

Incubation Period of hansen’s disease

A

5 years (6 months to 20 years)

has a subclinical stage where immunity must weaken before any lesion

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4
Q

Mode of transmission for Leprosy:

A

Droplet transmission

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5
Q

Susceptibility in Leprosy

A

Most people are actually only mildly susceptible

Factors:
Genetic
Repeated exposure

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6
Q

Etiology of Hansen’s disease

A

Mycobacterium leprae

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7
Q

Mycobacterium leprae

A

slow-growing
Doubling time of 2 weeks
Does not grow in culture media
Prefers cooler temp (27-35)

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8
Q

The clinical immunologic Spectrum Leprosy

A

Cell mediated Immunity

Antibody response

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9
Q

Cell Mediated Immunity

A

In the first phase; T cells and macrophages are the ones that respond to the bacteria

The T cells and macrophages are what we need to kill and contain bacteria

The T cells and a granulomatous reaction in the body if the cell-mediated immunity isn;t enough

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10
Q

Antibody Response

A

T cell response weakens and becomes an antibody-dominant response

strong AB response but useless

These AB cannot kill the bacteria therefore, this phase leads to more extreme cases of leprosy

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11
Q

Indeterminate Leprosy

A

some cases may resolve, while some may progress to full term

Patches may have loss sensation and when biopsied may have granulomatous infiltrates

Ill defined patch

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12
Q

Single or few, assymetrical, well defined hyppigmented, erythematous or copper colored patches with raised borders

no satellite lesion

A

Tuberculoid leprosy

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13
Q

Few, asymetrical, well demarcated, dry plaques. May be annular with clearly defined outer borders. Surface may be scaly

A

Bordeline TL

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14
Q

More numerous lesions than TL (>3 and <10 lesions)

Asymmetrical, less well demarcated, shiny plaques, often annular with sharply-marginated inner and outer borders

A

Mid borderline Leprosy

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15
Q

Numerous (>5) smaller,, rougly symmetrical, shiny, macules, papules, nodules, and plaques with sloping edges

Annular punched out lesions

A

Bordeline Lepromatous Leprosy

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16
Q

Very numerous, symmetrically distributed, erythematous or sopper colored, shiny macules

Presents with a lot of infiltration on the skin

A

LL

17
Q

Classifies cases of leprosy bases on clinical features

A

Ridley Jopling classification

18
Q

WHO classification of leprosy

A

Multibacillary

Paucibacillary

19
Q

Multibacillary Leprosy

A

> 5 skin lesions
+ AFB
1 nerve trunk involves

20
Q

Paucibacillary Leprosy

A

<5 skin lesions
NO AFB in skin smears
0-1 Nerve trunks involved

21
Q

MB - Ripley-jolling

A

Lepromatous
BL
BT

22
Q

PB- Ripley jopling

A

BT
T
Indertimate

23
Q

“Leprary reactions”

A

Cured persons with late reactions

Cured persons with residual disabilities

24
Q

2 nervess usually examined in Leprosy

A

Ulnar and common peroneal

25
Q

Diagnostic test of leprosy

A

Slit skin smear

Skin biopsy

26
Q

MDT of Lprosy

A

Rifampicin
Clofazimine
Dapsone

27
Q

A leprosy patient becomes non-infectious after taking MDT for _______ month

A

1 month

28
Q

Treatment for PB leprosy (Indeterminate, TT, BT)

A

Rifampicin 600mg once a month for 6 months

+

Dapsone 100 mg daily for 6 months

29
Q

Treatment for MB Leprosy( BT, BB, BL, LL)

A

Rifampicin 600 mg and Clofazimin 300 mg once a month

+

Dapsone 100mg and clofazimine 50 mg for 12 months or until skin smears show no more solid staining Bacilli

30
Q

Side effects for treatment of Leprosy

A

Rifampicin: Reddish urine

Clofazimine: Dark brown skin discoloration

Dapsone: Hemolytic anemia

31
Q

Medical Management of lepra Reactions

A

High Risk: MB + nerve impairment

Clinical indications

Nerve pain
Loss of sensation
Loss of function

32
Q

management of Mild Lepra reactions (Type 1 and 2)

A

Features: Mildly swollen skin lesion, Mild fever

Mild analgesics
Continue MDT
Do nerve function assessment every 2 weeks
Advise Bed rest

33
Q

Management of Severe Lepra reactions

A

Prednisolone x 12 weeks
and.or clofazzimine x 3months + continue MDT

Nerve Fx assessment every 2 weeks

Alagesics
Refer persistent, non responding reactions

34
Q

Severity grading for Lepra reaction

A

Mild - only the skin

Severe - skin, nerve and systemic

35
Q

Characteristics of Lepra reactions

A

Type I - reversal reaction

Type II -erythema nodosum leprosum

36
Q

Type 1 (Reversal Reaction)

A

Mostly borderline

Associated wih alteration in CMI due to sudden increase inCMI

37
Q

Type 2 (ENL)

A

Mostly lepromatous

Immune-complex syndrome due to precipitation of antigen and antibody complexes in tissues spaces, blood, lymphatics

38
Q

Peripheral nerve inflammation manifests into 2 ways in Leprosy

A
  1. Enlarged and/or very painful

2. Silent neuritis

39
Q

Impairment, disability and deformity

A

Claw hand

Foot ulcer - posterior tibial nerve

Foot drop - Peroneal nerve damage

Ocular complications - Facial or trigeminal nerve damage

OS 212 DERMATOLOGY (9 decks)

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