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Hanseníase (lepra)

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  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 10 Feb 2026
最后更新： 10 Nov 2022

小结

定义

病史和体格检查

关键诊断因素

  • presença de fatores de risco
  • lesões cutâneas típicas
  • acometimento do nervo
  • perda sensitiva
完整详情

其他诊断因素

  • reações imunológicas
  • lesões oculares
完整详情

危险因素

  • contato próximo com um indivíduo com hanseníase multibacilar
  • pobreza
  • residência em áreas endêmicas
  • predisposição genética
  • transmissão zoonótica
完整详情

诊断性检查

首要检查

  • raspado intradérmico
  • biópsia de pele e/ou de nervo e histopatologia
完整详情

需考虑的检查

  • reação em cadeia da polimerase
完整详情

治疗流程

急症处理

Multibacilar (MB) ou paucibacilar (PB): sem resistência à rifampicina ou fluoroquinolona

Multibacilar (MB) ou paucibacilar (PB): resistência à rifampicina ± fluoroquinolona

持续性治疗

reação do tipo 1 (reação reversa)

reação do tipo 2 (eritema nodoso hansênico)

Fenômeno de Lúcio

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
  • Hanseníase (lepra) images

  • Differentials

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    • Eczema
    • Tinha do corpo
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  • Guidelines

    • Towards zero leprosy. Global leprosy (Hansen’s Disease) strategy 2021-2030
    • Leprosy/Hansen disease: Contact tracing and post-exposure prophylaxis
    More Guidelines
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