小结
定义
病史和体格检查
关键诊断因素
- typical skin lesions
- nerve involvement
- sensory loss
其他诊断因素
- immunologic reactions
- eye lesions
危险因素
- close contact with a person with multibacillary leprosy
- poverty
- residence in endemic area
- genetic predisposition
- zoonotic transmission
诊断性检查
首要检查
- skin smear
- skin and/or nerve biopsy and histopathology
需考虑的检查
- polymerase chain reaction
治疗流程
multibacillary (MB) or paucibacillary (PB): no rifampin or fluoroquinolone resistance
multibacillary (MB) or paucibacillary (PB): rifampin ± fluoroquinolone resistance
type 1 reaction (reversal reaction)
type 2 reaction (erythema nodosum leprosum)
Lucio phenomenon
撰稿人
作者
Maria T. Ochoa, MD
Clinical Professor of Dermatology
USC Keck School of Medicine
Department of Dermatology
Los Angeles
CA
利益声明
MTO declares that she has no competing interests.
鸣谢
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.
同行评议者
Hubert Sansarricq, MD
Member of World Health Organization Panel of Experts on Leprosy
Saint-Armour Morlaas
France
利益声明
HS declares that he has no competing interests.
David M. Scollard, MD, PhD
Chief
Clinical Branch
National Hansen's Disease Programs
Baton Rouge
LA
利益声明
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
利益声明
AT declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
World Health Organization. Towards zero leprosy. Global leprosy (Hansen’s Disease) strategy 2021-2030. Apr 2021 [internet publication].全文
World Health Organization. Implementation of MDT. In: Multidrug therapy against leprosy: development and implementation over the past 25 years. Geneva: World Health Organization; 2004:45-68.全文
World Health Organization. Guidelines for the diagnosis, treatment and prevention of leprosy. Oct 2018 [internet publication].全文
World Health Organization. Leprosy/Hansen disease: management of reactions and prevention of disabilities. 2020 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Psoriasis
- Eczema
- Tinea corporis
更多 鉴别诊断指南
- Towards zero leprosy. Global leprosy (Hansen’s Disease) strategy 2021-2030
- Leprosy/Hansen disease: contact tracing and post-exposure prophylaxis
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