Indian Journal of Leprosy

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Uncommon Presentations of Leprosy
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-03) Yadav, AK; Gupta, AK; Rajkumar
Leprosy mainly presents typical features like hypopigmented, hypo anesthetic patch(es) with or without involvement of nerve(s). But in hyperendemic areas, the presentation may vary greatly, ranging from nodular, keloidal, or pustular forms of disease. We are reporting here three cases with uncommon presentations of leprosy which mimicked a wide range of dermatological conditions. The first case had a plethora of pustular lesions all over the body, resembling subcorneal pustular dermatosis (SPD). In the second case, a young male patient had just keloid-like plaques on his face; histology revealed that the condition was Histoid Hansen’s. The third case had two patches and a widespread, asymptomatic nodular eruption; the histology of this patient revealed the simultaneous presence of two distinct disease poles. All these cases developed de novo Hansen’s disease. In our cases, diagnosis was confirmed by bacteriological and histopathological assessment of patients. One of our patients presented with ‘Pustular erythema nodosum leprosum’ and another with atypical nodules and plaques mimicking other dermatological conditions. Thus, leprosy can be a “great mimicker”. Though such uncommon manifestations can also occur in low-endemic locations, these are likely to have higher incidence in hyperendemic places.
Rheumatological Manifestations of Leprosy- An Observational Study in a Tertiary Care Centre in North-Western India
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-03) Ketki; Singh, A; Maheshwari, R; Sarode, A
Leprosy commonly affects the skin and nerves but rheumatological manifestations in leprosy are not uncommon. Usually, the musculoskeletal manifestations of leprosy may remain under-diagnosed, especially when the patients present without any cardinal signs of leprosy. This study aims at evaluating the rheumatological manifestations presenting in biopsy proven cases of leprosy. This observational study was done in Department of Dermatology and Department of Rheumatology in Sawai Man Singh Medical College, Jaipur over a period of 2 years from January 2018 till January 2020. One hundred biopsy proven cases of leprosy were evaluated for rheumatological manifestations. Demographic profile, clinical features and type of leprosy were documented. Out of these 100 patients, 71(71%) were males and 29 (29%) were females. The most common type of leprosy in this study population was borderline tuberculoid leprosy (BT) (25%) followed by borderline lepromatous leprosy (BL) (22%). Type 2 reaction was diagnosed in 21(21%) cases. Arthritis was seen in 62 patients (62%) which was observed to be symmetric polyarthritis most commonly involving the knee, elbow joints and small joints of hands in 37(37%) patients while asymmetric oligoarthritis in 25(25%) patients. Arthritis was acute in onset in 26 patients (26%) while chronic, relapsing, symmetrical, peripheral polyarthritis affecting primarily the wrists, metacarpal and proximal interphalangeal joints of the hands were seen in 36(36%) cases. Arthritis, arthralgia, enthesitis were thus common rheumatological manifestations in leprosy seen in our study which may be the presenting complaint in the patients. Therefore, it is of utmost importance to recognize these manifestations early to prevent any error in diagnosis and treatment.
Dapsone Induced Agranulocytosis – A Report of Two Cases
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-03) Veeranna, S; Rohith, S; Ashwini, PK; R, Vinutha; Dugar, P
Dapsone is associated with many adverse effects, some of which are severe and can be fatal. Agranulocytosis is a rare idiosyncratic reaction seen with dapsone. We report two cases, one with leprosy and one with hidradenitis suppurativa who developed agranulocytosis following dapsone administration. Early detection and immediate withdrawal of the drug are essential steps in the management of this severe adverse drug reaction.
Hansen’s Disease Mimicking as Papulosquamous Conditions
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Gaikwad, PS; Gadkar, SS; Agrawal, A; More, YE; Palaskar, NM
Hansen’s disease is a chronic granulomatous infectious disease caused by Mycobacterium leprae and Mycobacterium lepromatosis, primarily affecting skin and nerves, with a long incubation period. Depending upon bacillary load and host immunity, the clinical spectrum of leprosy is very wide. Leprosy, along with lepra reactions, can sometimes have uncommon clinical presentations, posing a diagnostic challenge leading to delayed treatment. We hereby present three cases of borderline lepromatous leprosy, two of them in type 1 lepra reaction, clinically mimicking papulosquamous conditions. Such scenarios with atypical presentations necessitate a keen clinical suspicion and confirmation with histopathological and microbiological examination, highlighting its role in early diagnosis, especially in endemic areas, for timely management of the disease.
Epidemiological Study of Co-infection of Leprosy and COVID-19 in the State of Mato Grosso, 2020
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-03) Alencar, RDSCSD; Damazo, AS
The COVID-19 pandemic has significantly impacted neglected diseases including leprosy leading to disruptions in global leprosy programs. Leprosy offers an intriguing model for investigating the impact of occurrence and severity of COVID-19. This study aimed to assess the risk of severe COVID-19 complications in patients with co-infection by COVID-19 and M. leprae through an exploratory spatio-temporal analysis of leprosy cases diagnosed in Mato Grosso. Brazil. Leprosy patient data was retrieved from the Notifiable Diseases Information System (SINAN) for 2018-2020. while COVID-19 patient data was obtained from the IndicaSUS system for 2020. The linkage of those databases yielded 861 true pairs. Leprosy cases showed a predominance of the population aged 15-59 (78.05%) and female (57.14%). Most cases were classified as multibacillary (94.43%). Among cases with co-infection. 28.46% had comorbidities. compared to 19.24% in the overall COVID-19 patient population. The fatality rate for co-infected patients was 4.88%. while the overall COVID-19 fatality rate was 2.32%. These findings indicate that leprosy can serve as a comorbidity factor for COVID-19 patients, elevating the risk of complications, including leprosy reactions. and potentially leading to fatal outcomes. Healthcare services for leprosy patients is crucial in the context of co-infection, such as COVID-19.
Cutaneous Sarcoidosis Treated as Leprosy
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Patil, RS; Marfatia, YS; Menon, D; Patel, B
Sarcoidosis is a multisystem disease of unknown aetiology characterized by epithelial cell granulomas without caseation in different organs. It involves mainly the mediastinal and peripheral lymph nodes, lungs, skin, eyes, liver and spleen. It acts as a great mimicker of various skin and systemic diseases. Diagnosis is challenging and mainly done by exclusion. Histopathology shows well-formed naked epithelioid cell granulomas and inclusion bodies. Corticosteroids are the mainstay of treatment. Herein we report a 60-year-old male, who presented with asymptomatic multiple erythematous well-defined plaques over face, trunk and upper limb clinically looking like lepromatous leprosy. He was earlier treated with anti-leprosy drugs (ALD) for 6 months as facilities for slit-skin smears and biopsy were not available at that time, following which he showed no improvement. There was no motor/ sensory deficit and skin smear for acid-fast bacilli (AFB) was negative. Skin biopsy was taken from a representative lesion. Histopathological findings were suggestive of sarcoidosis. He then started oral and topical corticosteroids along with PUVA therapy, following which he showed significant improvement. This report highlights the need to access to slit-skin smears and histopathology to confirm or rule out the diagnosis of leprosy.
Leprosy in a Psoriasis Patient – Rare Co-existence
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Mannu, A; Vasudevan, B; Lekshmipriya, K; Gera, V; Das, P; Kumari, L
Leprosy and psoriasis are two unique diseases of mankind used interchangeably till modern times. As our understanding of the pathogenesis of both diseases increased, rarer it became its coexistence. This rarity is because of a complex interaction between genetic factors, immunity, cytokines, neuropeptides, and keratinocytes. We report a rare case of psoriasis of 16 years duration, who developed numbness over both legs and hands of 8 months duration, diagnosed as a case of leprosy based on investigation. We report a rare coexistence of pure neuritic leprosy and psoriasis.
Rare Presentation of Type 2 Lepra Reaction with Suppurative Lymphadenitis and Pustular Sweets Syndrome-like Lesions
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Chauhan, S; Verma, GK; Negi, L; Singh, A
The unusual presentations of lepra reactions (LRs) or leprosy often warrant the exclusion of close mimickers especially if cardinal signs of leprosy are lacking. In such cases, demonstration of acid-fast bacilli (AFB) either on slit skin smear microscopy (SSS) or histopathology or on cytology can aid in early diagnosis of leprosy. Here a 72-year-old untreated case of leprosy is reported for atypical presentation of type 2 lepra reaction (T2LR) in the form of massively enlarged, generalized lymphadenitis with secondary suppuration in groin and axillary groups. The patient also had fever, constitutional symptoms, sweets syndrome-like tender plaques, and pustules over the extensors of the extremities. Despite having visible deformities in her hands for the past 10 years, the patient denied any treatment for leprosy. The demonstration of AFB on lymph node cytology and subsequently on repeated SSS from ears confirmed the diagnosis of leprosy. After that other clinical possibilities like sweets syndrome with underlying lymphoma or concomitant tubercular lymphadenitis were excluded.
Necrotic Erythema Nodosum Leprosum : A Case Report
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Yuniasih, DI; Prawitasari, S; Widasmara, D; Retnani, DP
Erythema nodosum leprosum (ENL), the type-2 reaction in leprosy, is caused by a humoral immune response to Mycobacterium leprae. Severe ENL can lead to vesicular or bullous manifestations known as necrotic erythema nodosum leprosum (ENL). Despite the classic presentation of erythema nodosum, severe ENL very rarely presents as an ulcerative skin lesion. Necrotizing ENL is a rare manifestation, characterized by vesicular or bullous lesions resulting in necrotic ulcers preceded by constitutional symptoms of fever. Our patient was diagnosed with leprosy 19 years ago, was irregular in taking treatment and presented swelling in the lower leg with skin color changed to brownish purple. Based on clinical and histopathology the patient was diagnosed as necrotic ENL and treated with MDT and methylprednisolone. Patient consumed the medication for 3 weeks, the lesions turned into necrotic tissue, however, the patient died in the third week due to septic bacteremia. Atypical ENL manifestations require attention in diagnosis to start timely appropriate management.
Proximal Nailfold Capillary Patterns in Multibacillary Leprosy Patients: A Case Series Study
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Sudhakar Rao, KM; Eshritha, C; Aruna, MS
Due to disabilities and disfigurement caused by leprosy it has been a feared illness since antiquity. Leprosy remains the most common infection that leads to disability. Skin and peripheral nerves are the main targets of leprosy. Nailfold capillaroscopy (NFC) is a non-invasive imaging technique that is used for assessment of proximal nailfold capillaries. The objective of the study is to observe the different nailfold capillaroscopic patterns in patients with multibacillary leprosy. A total of 10 multibacillary leprosy patients were enrolled for nailfold capillaroscopic examination using a Foto-Finder video dermoscope. Among these 10 cases, 5 (50%) were borderline lepromatous (BL) leprosy, 2 (20%) were lepromatous leprosy (LL) with type 2 lepra reaction and 3 (30%) lepromatous leprosy (LL) with trophic ulcers. The age of the patients ranged from 20 to 70 years. Most common nailfold capillaroscopic findings seen in this study were avascular areas, meandering vessels and dilated vessels. Invasion of microvasculature and molecular adhesions by Mycobacterium leprae could be responsible for morphological changes observed in these cases. Diagnostic / prognostic value of these findings needs to be established by data captured in well characterized comparable leprosy cases in different settings. These capillaroscopic findings are to be studied in the context of clinical, histopathological and bacteriological findings, then to be analysed with reference to vascular and neurological involvement.
A Glimpse of Present Day Perspectives of Stigma Associated with Leprosy : A Qualitative Study from a Tertiary Care Centre in Tezpur area of Assam, India
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-03) Sharma, L; Agarwal, R; Dadhich, K; Dinker, Y
Since time immemorial, Leprosy is linked with stigma and discrimination mainly due to lack of proper knowledge and understanding of the disease. The attitude and beliefs of people and society add to the preexisting situation(s). This affects the status of individual in society, social and occupational life. As social beliefs change with the time and vary from area to area, this study has been carried out to understand the present-day perspectives of stigma associated with leprosy Assam and its impact among patients of leprosy and community members. Specifically, this study aims at understanding as how the gender relations affect access to resources, decision making, and division of labour in patients of leprosy. This qualitative study has been conducted in a Tertiary Care Centre in Tezpur area of Sonitpur district of Assam, a state of Northeast India, to explore the present-day perspective of leprosy affected individuals and society towards the disease particularly the impact of leprosy on the patients’ mental health, marriage, social interaction, and employment. Data was collected through 6 focused group discussions including 90 participants (24 patients of leprosy receiving treatment from the hospital. The other respondents were non leprosy patients which included 42 family members, 16 colleagues, 8 health care workers), in–depth interviews and questionnaires involving the patients of leprosy and their close family members being attended at this centre. It was observed that the family members especially first-degree relatives and spouses had a major role tackling situations arising out of social stigma of the disease specially in patients dealing with reactions and deformity. Hospital staff were largely found to have a positive outlook on the disease process and evolution. There was no stigma or discrimination attached with delivery of health care services in our study. Our study also provides an overview of the impact of leprosy on the mental health on the patients and family members due to disease, reactions and deformities.
Leprosy and Lupus: Concurrence or Epiphenomenon
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Parekh, A; Shah, H; Chavda, A
Leprosy and systemic lupus erythematosus (SLE) share many clinical and laboratory characteristics. Azulay coined the term “autoaggressive hanseniasis” (AH) to describe multibacillary leprosy cases exhibiting clinical and immunologic features reminiscent of autoaggressive connective tissue diseases. This article presents the case of a 20-year-old Nepalese woman diagnosed with borderline lepromatous leprosy, demonstrating both clinical and laboratory evidence of autoimmune connective tissue disease. Treatment comprising a multidrug leprosy regimen alongside thalidomide and corticosteroids led to a remarkable clinical improvement. The discussion emphasizes the importance of recognizing rheumatic symptoms in leprosy cases, thereby averting misdiagnosis with autoimmune disorders, and underscores the therapeutic efficacy of thalidomide. Furthermore, we endeavor to address the diagnostic challenge surrounding autoaggressive hanseniasis in contemporary practice, pondering whether it represents a distinct clinical entity or manifests as multibacillary leprosy with clinical-serological evidence of autoimmune connective tissue diseases.
A Cross-sectional Study to Assess the Mental Health Status of Leprosy - Affected Persons in Hyderabad, Telangana, India
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-03) Anusha, V; Mohiuddin, SA; Ananda, KG; Bhavani, K; Reddy, SA
Leprosy is a chronic infectious disease that not only affects the physical health of a person but also has profound emotional and psychological effects which adversely affect their mental health. The insights gathered from this study will aid in addressing the challenges faced by leprosy patients and in creating effective strategies to enhance their mental health. The objectives were to determine the prevalence of mental health disorders among leprosy-affected individuals and to identify the factors that impact their mental health. A cross-sectional study was conducted among leprosy-affected individuals aged 18 years and older who were receiving treatment at the Sivananda Rehabilitation Centre in Hyderabad from April to August 2022. A semi-structured questionnaire was administered to 200 individuals. This questionnaire included questions on sociodemographic factors, degree of physical deformity, and family support, as well as mental health status, which was assessed using the DASS-21 (Depression, Anxiety, and Stress Scale). The mean age of leprosy-affected individuals was 44.1 ± 14.8 years old. 53% of the patients were illiterate. The prevalence of depression, Anxiety and Stress in leprosy-affected individuals was found to be 12.5%, 19% and 3%. Depression was associated with younger age and higher socioeconomic status while anxiety was associated with unemployment and whose family left after diagnosis. These findings highlight the importance of addressing the mental health needs of individuals affected by leprosy.
Health-Related Quality of Life Study of Leprosy Affected People of a Leprosarium of Northern India
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-03) Bhat, L; Khan, N; Vaida, N; Hassan, I; Banday, MT
The quality of life (QoL) of leprosy-affected people (LAP) of a leprosarium at Srinagar, Jammu & Kashmir, India were assessed across sociodemographic, dermatology, and neurological factors using DLQI, WHOQOL- BREF, and DN4 questionnaires and statistically analyzed using IBM SPSS. QoL of LAPs measured through DLQ1 and WHOQOL-BREF was found to be low with most leprosy affected people having a significant effect of leprosy disease on their QoL, the highest affected domain was social relationship followed by psychological domain. QoL had a strong relationship with age, gender and type of leprosy disease; with progression in age the QoL impairments increased; more QoL impairments in females than males and multibacillary (MB) disease rather than paucibacillary (PB category) of leprosy that showed lesser QoL impairments. Females experienced more neuropathic pain than males, and quality of life in the social relationship followed by the psychological domain were worst affected and were found to have a strong correlation with age, gender, and disease category. QoL was also observed to be severely affected due to the pain and disability associated with the leprosy, and psychological, social, and environmental factors contributed to its reduction. A multi- font strategy towards improving the quality of life may include several measures such as early diagnosis and treatment ; active surveillance and treatment of wounds to reduce the intensity of pain; organization of rehabilitation programmes; creating occupational opportunities and continued counselling to reduce diverse social and psychological complexities, and reintegration with the society to reduce social exclusion.
Study of Clinico-epidemiological Profile and Treatment Outcome of Leprosy Cases as Per Recent National Leprosy Eradication Programme in an Urban Area of Western Maharashtra - A Longitudinal Study
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Anand, V; Kunte, R; Jathar, S; Singh, P
Leprosy is a chronic infectious disease which affects skin, peripheral nerves, limbs and eyes. National leprosy Eradication Programme (NLEP) gives emphasis on early detection of cases, treatment completion & disability limitation. The newer initiatives are more focused on high prevalent regions while there are few low prevalent regions where prevalence rate is increasing. In view of the recent thrust on leprosy eradication it was felt necessary to study the current profile of leprosy patients including their disabilities & outcome to treatment in a low endemic region. A longitudinal study was carried out in urban leprosy unit and urban health centres of Pune city of Maharashtra. A clinico-epidemiological analysis of all leprosy cases from Oct 2017 to Sep 2018 was done using semi-structured questionnaire and clinical examination. Treatment outcome of all leprosy cases was assessed for entire treatment duration along with evaluation of NLEP using few selected indicators. A total of 89 patients were included in this study who were examined and followed up for treatment duration for clinico-epidemiological profile and treatment outcome. Mean age of study participants is 35.7 years with standard deviation of 15.16. Study showed a very high proportion of multibacillary cases (93.3%). Approximately 27% participants belong to lepromatous leprosy (LL) spectrum while 3.4% to tuberculoid spectrum with rest 70% cases reported as borderline leprosy (BT, BB & BL). In the current study it was observed that 25.8% participants had grade 1 deformity and 11.2% had grade 2 disability (G2D). Majority were released from treatment (88.7%) after completion of MDT while rest could not complete treatment due to various reasons. High percentage of multibacillary cases among new cases and high G2D are indicators of late detection of cases in the community. Few leprosy cases during the study found to have refused treatment. It is recommended that further efforts should be made by the government for raising awareness and empowerment of community so that leprosy cases report early and are treated appropriately.
A Retrospective Hospital Based Study on Deformities in Leprosy Patients in Leprosy Elimination and Post Covid Era in Southern India
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Spandana, KD; Shetty, UM; Aishwarya, R; Mahalaxmi, K; Shilpa, K
Mycobacterium leprae is the causative agent of leprosy, a chronic illness that affects skin, and peripheral nerve system. Even after leprosy was officially proclaimed eliminated as a public health issue in India in December 2005, new leprosy cases continue to arise. While leprosy can be easily treated in most cases, disabilities in a section of leprosy are cause of immense concern. This study has been carried out to analyze the grade and type of deformity among leprosy patients attending Dermatology Department of Bangalore Medical College, a tertiary care hospital. The present retrospective hospital-based study was carried out on all leprosy patients attending Dermatology (outpatient and inpatient) with deformities were included in the study from 11 January 2023 to – 11 January 2024. 52/122 total leprosy cases (41.8%) attending our hospital had deformities/ disabilities. Out of a total 51 patients with deformities, thirty-six (70.6%) were male and 15 were female (29.4%), the mean age observed in our patients was 38.84 years. Most cases had lepromatous leprosy. Out of 51 patients, twenty-six cases (50.98%) had grade 1 deformities, and 25 cases (49.01%) had grade 2 deformities. Forty (78.43%) had a history of reactions. Forty-one (80.39%) cases were multibacillary (MB) and 10 (19.6%) patients were paucibacillary (PB) types. Clinical examination and basic examination can identify a variety of deformities. Early detection of illness and abnormalities can aid in informing patients about leprosy and preventing the disease’s progression to serious consequences, especially those resulting in disabilities. More extensive MB disease and reactions appear to be associated with disabilities. Two-third of the patients in this group reported with disabilities/ deformities which indicates the problem of access to early and appropriate management of leprosy and its complications. Whether the problem is due to ignorance or due to other enabling factors should be investigated. The present study indicates the need for further in-depth studies and appropriate interventions at community level.
Black Dots and Broken Hairs in Leprosy Unveiled by Dermoscopy
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-09) Verghese, HR; Rao, KM Sudhakar
Leprosy, caused by Mycobacterium leprae, is a chronic infectious disease which presents with varied clinical manifestations primarily affecting the skin and peripheral nerves. This study reports a 15-year-old female with light- colored skin lesions, sensory loss, and hair loss on the shins. Clinical examination revealed multiple hypopigmented patches with sensory deficits. Dermoscopic evaluation showed reduced white dot density, scaling, broken hairs, and black dots against a yellowish background. Dermoscopy appears to be useful in the diagnosis of leprosy and its timely identification for appropriate management. Further research is needed to establish standardized dermoscopic criteria for leprosy diagnosis and to assess its sensitivity and specificity in a larger patient population.
A Clinico-epidemiological Study of Disabilities in Leprosy Patients from an Endemic Area of Central India
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Chhabra, N; Peethambaran, AS; Choudhary, R; Sri, P; Ganguly, S
People affected by leprosy are at risk of impairment, primarily due to delay in diagnosis. Despite increased efforts, reports from various studies suggest that leprosy is usually diagnosed late, and a high grade 2 disability (G2D) rate especially in untreated cases indicates delayed diagnosis. The study aims to determine the percentage of disabilities among leprosy patients and the association of G2D with various clinical-epidemiological factors. This retrospective study was conducted on 123 leprosy patients attending the Dermatology OPD of AIIMS, Raipur (India) a tertiary care institute in Central India from July 2020 to March 2022. All leprosy patients, including new, partially treated, on-treatment, and released-from-treatment patients, were included in the study. Clinico-epidemiological details of all leprosy patients presenting during this period were noted. 95% (118/123) were of multibacillary (MB) type as per WHO classification. G2D was found among 52.8% (65/123) of leprosy patients included in the study among which 12.3% had already completed treatment and 87.6% were newly diagnosed or under ongoing multidrug therapy. Claw hand was found in 34%, and trophic ulcer was found in 22.7% of leprosy patients. This study shows G2D to be more common in younger age (<45 years), disease duration > six months, ? two nerve trunk involvement, Multibacillary cases with BI ?4, type 2 lepra reaction, and untreated/ undertreatment cases of leprosy; however, the difference was not statistically significant. The prevalence of G2D remains high in the post-leprosy elimination era due to multiple factors, the most important being the delay in initiating treatment and the magnitude of the burden of multibacillary cases. Community-based similar studies could better comprehend the extent and reasons of G2D in newly diagnosed, on treatment, and treated cases for implementing public health measures.
Lepromatous Leprosy Clinically Masquerading as Granuloma Annulare: An Atypical Presentation
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-09) Konda, D; Thota, SS; Pradeep, I
Diagnosis of leprosy is based on cardinal signs that include presence of an anaesthetic skin lesion, peripheral nerve enlargement, and/ or demonstration of M. leprae in skin smears. However, leprosy has diverse cutaneous presentations and can mimic skin lesions of large variety of other dermatological conditions, leading to delay in the diagnosis and treatment resulting in deformities and disabilities due to leprosy. We report one such case of Hansen’s disease that presented as granuloma annulare in a 28-year-old man due to characteristic discrete annual lesions all over the body and absence of sensory loss / nerve thickening. Patient did not respond to steroids. Slit-skin smears (SSS) from the lesion showed bacteriological index of 4+ and morphological index of 60%. Biopsy from the lesion showed the histopathological features of lepromatous leprosy. Patient responded well to MB-MDT. This case emphasizes the importance of clinical suspicion and use of known laboratory techniques like SSS from the lesions and histopathology.
History of Leprosy as Depicted in the Carakasamhita
(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2024-12) Das, S
Leprosy is one of the most dreaded and stigmatizing diseases. Although modern treatment methods have been introduced for leprosy, leprosy has not yet been eradicated even today. In Indian tradition, it is known as Kustha. The discussion and its traditional treatment dates back to ancient times. After the Vedas, Puranas, the Carakasamhita is a book that describes the causes, symptoms and treatment of leprosy in detail. The study and analysis of the issues mentioned in this book may have beneficial impact on the treatment of leprosy especially to manage complications of leprosy including nerve damage, trophic ulcers and disabilities.

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