Leprosy

Last reviewed: 6 Sep 2022
Last updated: 18 Feb 2020

Summary

Definition

History and exam

Key diagnostic factors

  • typical skin lesions
  • nerve involvement
  • sensory loss
More key diagnostic factors

Other diagnostic factors

  • immunologic reactions
  • eye lesions
Other diagnostic factors

Risk factors

  • close contact with a multibacillary leprosy patient
  • poverty
  • residence in endemic area
  • genetic predisposition
  • zoonotic transmission
More risk factors

Diagnostic investigations

1st investigations to order

  • skin smear
  • skin and/or nerve biopsy and histopathology
More 1st investigations to order

Investigations to consider

  • polymerase chain reaction
More investigations to consider

Treatment algorithm

ACUTE

multibacillary (MB) or paucibacillary (PB): no rifampin or fluoroquinolone resistance

multibacillary (MB) or paucibacillary (PB): rifampin ± fluoroquinolone resistance

ONGOING

type 1 reaction (reversal reaction)

type 2 reaction (erythema nodosum leprosum)

Lucio phenomenon

Contributors

Authors

Maria T. Ochoa, MD

Clinical Professor of Dermatology

USC Keck School of Medicine

Department of Dermatology

Los Angeles

CA

Disclosures

MTO declares that she has no competing interests.

Acknowledgements

Dr Maria T. Ochoa would like to gratefully acknowledge Dr Denis Paul Jacques Daumerie, a previous contributor to this topic. DPJD declares that he has no competing interests.

Peer reviewers

Hubert Sansarricq, MD

Member of World Health Organization Panel of Experts on Leprosy

Saint-Armour Morlaas

France

Disclosures

HS declares that he has no competing interests.

David M. Scollard, MD, PhD

Chief

Clinical Branch

National Hansen's Disease Programs

Baton Rouge

LA

Disclosures

DMS declares that he has no competing interests.

Alexandre Tiendrebéogo, MD, MPH

Medical Officer

Leprosy and Neglected Tropical Diseases in Central Africa Countries

World Health Organization

Country Office of Kinshasa

DR of Congo

Disclosures

AT declares that he has no competing interests.

  • Leprosy images
  • Differentials

    • Psoriasis
    • Eczema
    • Tinea corporis
    More Differentials
  • Guidelines

    • Guidelines for the diagnosis, treatment and prevention of leprosy
    • Global Leprosy Strategy 2016-2020: accelerating towards a leprosy free world
    More Guidelines
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer