paucibacilliary leprosy

paucibacilliary leprosy

tuberculoid leprosy; TT leprosy; see Table 1
Table 1: Presentations of Hansen's disease (leprosy)
Leprosy typeCharacteristics
Tuberculoid leprosy (TT) or paucibacillary leprosy (PB)Vigorous host resistance and low infection
A localized disease in patients with high cell-mediated immunity characterized by a single, clearly demarcated hypopigmented anaesthetic skin area of the face, hands or feet, with thickening of the subserving nerve
Borderline tuberculoid leprosy (BT)As TT, but more numerous, smaller skin lesions with thickening of peripheral nerves and deformity of the hands and feet
Borderline leprosy (BB)Numerous skin lesions of varying size and form (macules, papules, plaques) with punched-out, hypopigmented anaesthetic centres; widespread nerve involvement and limb deformity
Borderline lepromatous leprosy (BL)Large number of florid asymmetrical skin lesions of variable form, strongly positive to acid-fast bacilli
Lepromatous leprosy (LL) or multibacillary leprosy (MB)Severely compromised host resistance and massive infection Skin changes of the face, earlobes, buttocks, upper and lower limbs, peripheral oedema, rhinitis and loss of the outer one-third of the eyebrows are characteristic of the early stages, with later mucous membrane involvement causing nasal stuffiness, laryngitis and hoarseness, thence nasal septum perforation and collapse of the nasal cartilages (saddle-nose deformity), glove-and-stocking anaesthesia, gynaecomastia, testicular atrophy, ichthyosis, nerve palsies and neurotrophic resorption of the phalanges. Lucio's phenomenon (endarteritis and ulceration) is noted in Mexico and Central America