Leprosy

Question 1

Prototypic skin lesion of leprosy

Answer 1

TUBERCULOID SIDE
Single
Hypopigmented , can be erythmatous in rxn/face
Macules/ plaques
Well defined
May show Eipdermal atrophy
More loss of skin appendages(so absent hair sweating)
Anaesthesia

LEPROMATOUS SIDE
Multiple
"
Papules/nodules
Poorly defined
Epi and dermal atrophy
Hyposthesia to normosthesia

Question 2

First sensation to be effected

Answer 2

Temperature and pain

Question 3

Nerve involvement

Answer 3

Nerve thickening along with sign of nerve damage:motor / sensory loss

Question 4

Nerve involvement

Answer 4

Commonly palpated ones are:
Supratrochlear
Supraorbital

Radial
Ulnar
Radial cutaneous
Median

Lateral popliteal
Posterior tibial
Sural

Apart , a feeder nerve to the skin may be thickened

Question 5

Types of lepra reaction

Answer 5

Type1
Occurs in borderline leprosy(BT,BB, BL)
cause: alternation in CMI
Can be : upgrading(BL-BB-BT), downgrading (BT-BB-BL)
Manifestations: prexisting lesion edema, erythema ,scaling
New lesions
Neuritis

Type2/ERYTHEMA NODOSUM LEPROSUM
Occurs in LL, BLA
cause:immune complex rxn
Manifestations: skin lesions
Neuritis
Fever
Arthralgia, orchitis , iridocyclitis