lepra


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Related to lepra: leprosy

leprosy

 [lep´ro-se]
an inflammatory disease caused by Mycobacterium leprae, manifested in various ways, depending on the host's ability to develop cell-mediated immunity. It is a chronic communicable disease characterized by the production of granulomatous lesions of the skin, mucous membranes, and peripheral nervous system. Not readily contagious, it often results in severe disability but is rarely fatal. Called also Hansen's disease. adj., adj lep´rous.
Frequency and Transmission. Leprosy is essentially a tropical disease, although it has occurred in every country in the world. According to the World Health Organization, the number of leprosy patients in the world was less than 600,000 at the beginning of 2001. Its control remains a problem in six countries: Brazil, India, Madagascar, Mozambique, Myanmar, and Nepal.

Leprosy is not inherited, but the actual means of transmission have not yet been established. It is known that the source of infection is the discharge from lesions of persons with active cases. It is believed that the bacillus enters the body through the skin or through the mucous membranes of the nose and throat. Leprosy is considered one of the least contagious of infectious diseases; only 3 to 5 per cent of those exposed to it ever contract it.
Symptoms. The average incubation period of leprosy is 3 years. Initially, the infection is confined to the sheaths of nerves in the dermis. The disease progresses by spreading up the nerve sheath, resulting in loss of sensation, or by forming subcutaneous nodules and skin lesions.

In the lepromatous type, open sores later appear on the face, earlobes, and forehead, with tests showing large numbers of bacilli in the discharge from these lesions. If progress of the disease is not checked by treatment, the fingers and toes disintegrate and there may be other disfiguring due to trauma to the insensitive extremities. Death may occur in extreme cases of this type, but more often it is due to a secondary infection, such as tuberculosis or pneumonia.

In the tuberculoid type, there is loss of sensation on sections of the skin and atrophy of muscles. This often results in contraction of the hand into a claw.

Leprosy is further classified as either paucibacillary or multibacillary according to whether there are fewer or more than five lesions or patches present.
Treatment. Leprosy is most effectively and inexpensively treated with sulfone medications, such as dapsone, developed around 1950. In cases of sulfone resistance, the drug clofazimine (Lamprone) may be prescribed. A semisynthetic antibacterial, rifampin, is very effective in killing leprosy bacilli rapidly, so that patients receiving it may be considered minimal public health risks within a few days after treatment is begun. However, these drugs are expensive, have serious side effects, and are not readily available in many countries.

Treatment continues for several years at least, and sometimes indefinitely. In addition to specific medical therapy, adequate rest, diet, and exercise are provided. Physical therapy is employed to retrain affected muscles. Psychiatric help, not only for leprosy patients but for their close contacts and those who only imagine they have been exposed, is invaluable in relieving the anxieties arising from the age-old misconceptions about the disease.
Prevention. Preventive measures include establishment of clinics and hospitals for diagnosis and treatment. Early diagnosis and prompt treatment with multidrug therapy are key to prevention. Many patients return to their homes completely free of symptoms and are able to resume normal lives. Cure has been most successful in cases that were diagnosed and treated at an early stage, especially among the young.

Among the public health measures used to prevent leprosy are the laws in most countries requiring that all cases be reported to the local authorities and that all discharged leprous patients be examined at six-month intervals. Most countries also refuse entry to immigrants known to be infected. In the United States, information about leprosy, as well as treatment, can be obtained from the Gillis Long Hansen's Disease Center, Carville, LA 70721, telephone 800-642-2477.

lepra

An older term for:
(1) Leprosy, see there;
(2) Psoriasis, see there.

lepra

Leprosy (HANSEN'S DISEASE).
References in periodicals archive ?
--Baciloscopia inicial con indice bacilar (IB) de 2,2 sin estudios de morfologia, se confirma diagnostico bacteriologico de lepra multibacilar.
Los informes oficiales procedentes de 103 paises de 5 regiones de la OMS, la prevalencia mundial de la lepra registrada a finales de 2013 fue de 180 618 casos, mientras que el numero de casos nuevos notificados en el mundo ese mismo ano fue de 215 656, en comparacion con 232 857 en 2012 y 226 626 en 2011.
Histological diagnosis of upgrading Type 1 lepra reaction (T1R) was made when a biopsy revealed features of leprosy with the presence of a richer infiltrate of protective cells such as lymphocytes and/or giant cells (with or without dermal oedema) with respect to leprosy of a similar spectrum without reaction.
Pensando-se na carga estigmatizante e de exclusao que acompanha a doenca por periodo milenar, e compreensivel que a historia da lepra se reproduza no presente, influenciando o processo de adoecimento em hanseniase por remeter ao preconceito e crencas do passado arraigado em ideias preconceituosas e mitos firmados no imaginario do senso comum (6).
En este ambiente gris, Judas visita a su madre, degradada, deformada por la lepra; la mata, se duerme junto a su cuerpo, luego despierta y la quema, frente a los demas leprosos.
Se trata de un cuadro de hipersensibilidad inmune asociado a estado febril agudo que ocurre en el 60-75 % de pacientes con lepra MB, 10 % BL y 20-47 % LL.
69.- El problema de la lepra que existe desde que la Armada tomo a su cargo la isla, hace mas de 50 anos, sigue igual que entonces, habiendose solo conseguido en el ultimo tiempo mejorar las instalaciones del Leprosario.-Estimo que ya no puede dejarse pasar mas tiempo y que la Armada y el Gobierno tienen la obligacion de afrontar este problema en forma integral.-
El primer hospital para enfermos de lepra se creo en 1535 en la ciudad de Cartagena, y con el paso de los anos, la expansion de la ciudad y la necesidad de alejar a los enfermos, el hospital se fue reubicando en lugares cada vez mas lejanos de la ciudad, pasando inclusive a la isla de Tierra Bomba, en la que anos mas tarde fue fundado uno de los lazaretos mas antiguos del continente, el de Cano de Loro (3).
In Hyderabad site, LEPRA India's Blue Peter Public Health and Research Centre is managing microbiological component of the study and partnering with Gandhi Medical College and Hospital for gynaecological component.
El paciente asistio el dia 13 de diciembre de 2012 a control dermatologico, fecha en la que se prescribe 1 tableta de Talidomida de 100mg cada noche, 1 tableta de ibuprofeno de 400mg cada 12 horas y PQT (1 Blister) y se cita a control medico el diez de enero de 2013, con notificacion al Instituto Nacional de Salud (INS) de "Recidiva de lepra lepromatosa multibacilar" con codigo de evento numero 450.