Indian Journal of Leprosy
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Item Is Trans-epidermal Elimination of Mycobacterium leprae in Histoid Leprosy, a Risk Factor for Transmission? � A Report(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-03) Antakanavar, GM; Kumar, LP; Barman, KD; Mallya, V; Pandey, N.Histoid leprosy (HL) constitutes a rare variant of multibacillary (MB) leprosy characterized by distinctive clinical and histopathological characteristics. Herein, we present family cluster of three cases with HL as likely source of transmission. Eleven-year-old male child brought by mother had been diagnosed as borderline tuberculoid leprosy with type 1 lepra reaction. Incidentally we noticed histoid leprosy in mother. Later in histopathological examination revealed classical trans-epidermal elimination (TEE) of lepra bacilli. This had cautioned us investigate other family members, interestingly we noticed indeterminate leprosy in one of the female children. All three patients were treated, and family members were given chemoprophylaxis. This pattern of occurrence of leprosy in family especially in patient with histoid leprosy should be investigated thoroughly. The high bacillary load and the nature of the disease to shed the lepra bacilli through skin along with aerosol route could be potential modes of spread. Hence this report emphasizes on importance of TEE of lepra bacilli in leprosy transmission.Item Care of Anaesthetic Areas in Leprosy(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-03) Gupta, P; Priyanka; Sirka, CS.Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. Characteristic feature of leprosy is loss of sensation on skin. The loss of sensation in leprosy is either due to organism directly invading nerve and/or granuloma compressing the nerve fibres. Failure to protect anaesthetic area from noxious stimulus like pinprick, and external temperature may evoke development of injury (trophic ulcer) and lack of activity may produce deformity. Hence, there is an urgent need for educating and bringing awareness about the skin care in physicians, nursing and other health care professionals as well as patients/ leprosy affected persons. This article discusses various ways to protect the anaesthetic areas and care for trophic ulcers in leprosy patients/ leprosy affected persons. The care includes general measures like inspecting anaesthetic areas daily for ulcers or impending ulcers, avoid barefoot walking, use of appropriate measures for protecting anaesthetic areas (handling objects of extreme temperatures with gloves, educating patients for use of available devices for the prospect of anaesthetic area or trophic ulcer). Educating patients/ leprosy affected persons about the method of emollients application for minimizing the dryness and fissuring at the anaesthetic area is important.Item Dual Perforations: Hard Palate with Nasal Septum - The Exceptional Presentation of Lepromatous Leprosy(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-03) Desai, K; Vahora, R; Ajbani, A.Palatal and nasal septal perforations are rare manifestations of lepromatous leprosy. Here, we are reporting a case of a 43-year-old man who presented with regurgitation of food into the nose, recurrent foul-smelling nasal discharge, along with leonine facies, loss of hand grip, and loss of sensation in bilateral legs. Endoscopic examination revealed two full-thickness hard palate perforations with nasal septal perforation. The diagnosis of lepromatous leprosy was confirmed with histopathology of the biopsy from the skin as well as the margin of the palatal perforation, along with confirmation through a slit skin smear.Item Pure Neuritic Leprosy Primarily Presenting with Lymphadenopathy in Complex Lepra Reaction(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-03) Luthra, P; Nikam, B; Jamale, V; Hussain, AA; Bhale, G; Pandey, N; Singhal, R.Leprosy, an infectious disease with multifaceted manifestations, often presents diagnostic challenges, particularly in atypical cases lacking characteristic skin lesions. Herein, we describe a rare case of pure neuritic leprosy (PNL) presenting with lymphadenopathy and fever, initially misdiagnosed as tuberculous lymphadenitis. A 20-year-old female exhibited bilateral painful inguinal lymphadenopathy, fever, and shooting forearm pain. Despite extensive diagnostic evaluations, including histopathological examination, the initial diagnosis remained elusive. Subsequent investigations, including nerve biopsy, revealed borderline tuberculoid leprosy with lymphadenopathy, highlighting the importance of considering leprosy in cases of fever and lymphadenopathy, even in the absence of typical skin manifestations. Early recognition and appropriate treatment are crucial to prevent complications and ensure optimal patient outcomes. This case underscores the necessity for heightened clinical suspicion and comprehensive evaluation to avoid diagnostic pitfalls and facilitate timely intervention in leprosy cases with atypical presentations.Item The Unique Leprosy Helpline in India(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-03) Agarwal, A; Meena, SN; Ritu, KM; Bhargava, S; Jain, A; Kumar, P.The NLR India has established a helpline named Vikalp with objectives of improving the adherence to MDT, promoting practice of self-care among new patients with disabilities, and promoting SDR-PEP among the household contacts of the patients. This helpline is operating since May 2021 from Jaipur (Rajasthan) is providing a follow-up mechanism for leprosy patients on treatment complementing the government delivery system. The counsellor calls the patient every two weeks, sometimes the patient also calls. Every month, the helpline submits a report to the district leprosy officer (DLO) who ensures further need-based support to the patient. Through its two years of operation serving six districts of Jharkhand, Rajasthan and Uttarakhand; the helpline has been able to counsel 218 patients on treatment, 81% of defaulters re-start multi-drug therapy (MDT), 53% of ulcers healed and some household contacts of the patients administered single-dose rifampicin (SDR) post-exposure prophylaxis (PEP). The initiative has been selected as a best practice by the Central Leprosy Division, Government of India. This strategy has potential for scale-up in India and similar settings elsewhere.Item Bone Changes in Leprosy(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-03) Singh, R; Dutta, B.Specific and non-specific changes in the bones have been known for many years. With the availability of early and effective multi-drug treatment, there has been a decline in multibacillary and extensive forms of leprosy, but some patients still bear the brunt of deformities. This study aimed to identify early bone changes in patients even without overt clinical deformities. As studies on cases without overt clinical deformity in recent times are rare, this study has been carried out. A total of 55 patients suffering from leprosy who presented to Dermatology Outpatient Department (OPD) and Upgraded Urban Leprosy Centre attached to Dermatology OPD of Gauhati Medical College were included in this study. Radiological examination was carried out to detect any bone changes in all patients and correlated with clinical findings. Among the 33 patients with bone changes on radiological examination, 36.4% (n=12) patients had specific and 69.7% (n=23) had nonspecific bone changes. Osteoporosis was present in 30.3% (n=10) of patients. Bone changes in skull and paranasal sinuses were found in 21.2% (n=7) of patients. More than one type of bone change was present in many patients involving multiple limbs. In patients without visible deformities, specific bone changes were found in 18.2% of cases, including bone cyst, while nonspecific bone changes were seen in 45.5% (n=5) of cases, including bone spur. Awareness and detection of such changes will enable the clinicians to consider timely measures and prevent their onset and progression.Item Crescentic Glomerulonephritis in a 65-year-old Male Patient with Lepromatous Leprosy: Case Report(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-06) Bhutani, P; Kumar, A; Dhar, M; Pathania, M.Leprosy, a chronic infectious disease caused by Mycobacterium leprae, can involve multiple organ systems; however, renal manifestations are uncommon and often under-recognized, especially in the geriatric population. We report a rare case of a 65-year-old male with untreated multibacillary leprosy who presented with acute kidney injury and respiratory distress. Further evaluation uncovered an uncommon glomerular pathology (necrotising crescentic glomerulonephritis) necessitating both immunosuppressive therapy and multi-drug treatment for leprosy. This case highlights the diagnostic and therapeutic challenges in the geriatric population, where age-related changes, comorbidities, and atypical presentations can delay diagnosis. It underscores the importance of maintaining a high index of suspicion for leprosy and its systemic complications梚ncluding glomerulonephritis梕specially in older patients, where it is often overlooked. Early diagnosis through renal biopsy facilitated appropriate management in this patient. The case emphasizes the importance of integrated, multidisciplinary, and accessible healthcare approaches for older adults with leprosy, particularly those presenting with multi-organ involvement.Item Analysis of the incidence of Leprosy in Rio Grande do Norte - Brazil: 2012 to 2022(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-03) Kramer, DG; Serafim, MPG; de Ara鷍o, TCV.Leprosy is a chronic disease and can compromise nerves, skin and mucous membranes, being endemic in Brazil. Studies on the incidence in some regions are important for greater debate on the topic. The objective of this study was to evaluate the epidemiological characteristics of the incidence of leprosy in Rio Grande do Norte between the years 2012 and 2022. The data were collected in the Notifiable Diseases Information System, with the collection of sociodemographic data and clinical aspects of leprosy. The data were tabulated and analyzed using Excel software. In this study, 3,041 cases were identified, 53.93% men; 69.26% brown/ black; 94.74% over 15 years old and 76.24% with low education. The diagnostic classification of leprosy showed statistical relevance, in the chi-square test, for the variables sex (p = 1.9�-16); age group (p=2.5�-16) and education (p = 2.0 � 10-8). In the clinical aspect, it was observed that 31.33% of the reported cases presented multiple skin lesions; 19.50% had positive smear microscopy; 34.96% were treated as multibacillary; 29.96% had neuronal impairment and 75.38% were cured. Thus, the implementation of active search, guidance on self-care and treatment of this disease is justified for reducing transmission and physical disability.Item Spatiotemporal Changes of Leprosy in the 11 Districts of National Capital Territory of Delhi, India(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-06) Baghotia, KS; Rao, PSS.Leprosy caused by Mycobacterium leprae, has a very long and distinguished history with varying endemicity globally. Spatiotemporal analyses have helped to pinpoint areas where more intensive and effective control strategies are needed. The monthly progress reports of the National Leprosy Eradication Programme (NLEP) are excellent sources of studying the spatial temporal changes. These secondary data were used to analyses the changes over the 11 districts of NCT. Multibacillary (MB) rates vary from a low of 61.4% to a high of 86.0%. There are variations in child% and female% also but not closely correlated with the MB rates. While the mean new case detection rate (NCDR) is lowest in New Delhi, 1.2 (SD 0.6), the highest is in Shahdara, 18.4 (SD 2.1). The prevalence rates also show wide fluctuations, NCDR shows a decline from about 7/100,000 to around 4/100,000. The prevalence rate (PR) kept on fluctuating from 0.7 to 0.4 / 10000 population. Deeper analyses of the NLEP data especially the multi-bacillary cases in terms of socioeconomic and environmental factors might be productive in detecting possible areas for more intensive control programs including education and surveys of children and women. Further research on the secondary data will help clarify possible gaps in the programs and more intensive follow-up of high MB cases.Item Revisiting the Eye-Hand-Foot Score as a Simple Tool in Assessing the Disability Progression in Leprosy Patients in India(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-06) Pilaka, KR; Pallapati, MS; Simic, M; Lockwood, DNJ; Srikantam, A.The Global leprosy strategy 2021-2030 emphasizes managing leprosy and its complications and preventing new disabilities as one of its strategic pillars. This study assessed the impairment status of newly diagnosed leprosy patients, at the beginning and end of the multi-drug therapy by using the Eye, Hand, and Foot (EHF) score. The study also analyzed the socio-demographic and clinical factors associated with the worsening of the EHF score. This retrospective study was based on case-records of patients who were diagnosed with leprosy, registered for treatment and completed treatment in 6-9 months for paucibacillary cases and 12-18 months for multibacillary (MB) cases in a secondary level leprosy care center India, from April 2010 to March 2020 were analyzed. Out of 531 records of newly diagnosed leprosy cases, 232 met the inclusion criteria. At diagnosis, the mean EHF score was 1.49, and at the end of treatment, it was 2.13, which was 0.63 higher than at diagnosis (p < 0.001). While the worsening of EHF scores was observed in 38.3% of 232 patients, only 5.6% deteriorated by WHO grading. Worsening of the EHF Score after treatment occurred with increasing age (OR: 1.03, 95% CI, 1.01-1.06), being illiterate (OR: 2.86, 95% CI, 1.50-5.46) and having MB type (OR: 4.43, 95% CI, 1.30-15.1) and lepromatous type (OR: 1.80, 95% CI, 0.90-3.60) leprosy. To conclude, our findings underscore the need for utilizing the EHF score in monitoring leprosy-related disabilities in addition to WHO disability grading system. Continued surveillance during MDT and regular nerve function assessments and treatment of neuritis when detected, are critical to mitigate disability progression among high-risk patients like being illiterate, multibacillary and lepromatous type of leprosy, ultimately reducing the risk of developing grade 2 disability.Item Visible Deformity after HD (Leprosy) Chemoprophylaxis among Tribal People in India: Quantitative Analysis of Data Extracted from Published Sources(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-06) Almeida, JG; Talhari, S; Salgado, CG; Kumar, B; Talhari, CC; Goncalves, HS.This is a quantitative analysis of data concerning visible deformity among newly diagnosed Hansen抯 disease - HD (leprosy) patients in Dadra Nagar Haveli, India, before and after the introduction of chemoprophylaxis. Chemoprophylaxis was introduced on 1 April 2015 and consisted of a rifampicin dose >10 mg/kg for contacts of nearly all 損rimary� patients who were newly diagnosed from 1 April 2013 until 2017. The population had repeated door-to-door surveys in the two years before the introduction of chemoprophylaxis. Data was extracted from published sources. The variation in the annual number of newly diagnosed HD patients with visible deformity in this population in any given year was predictable to the extent of over 90% by the number of contacts in this population who had received chemoprophylaxis in the preceding year (p =.0002, R2 = 0.9132). The population incidence rate of newly detected visible HD deformity at HD diagnosis increased substantially, from <2/million population/yr during 2010 to 2014 to >60/million population/yr in 2016, the year following the 2015 introduction of chemoprophylaxis. The evidence suggests that brief chemoprophylaxis among asymptomatic contacts of newly diagnosed HD patients was an important factor in the causation of visible deformity among newly diagnosed HD patients in this population. Biological plausibility is discussed. By contrast, the frequency of visible HD deformity typically declines between the start and end of full MDT treatment backed by a package of nerve function monitoring and holistic care. Consequently, it is recommended that the underlying biology of visible deformity after brief chemoprophylaxis be elucidated further by non-human experiments before exposing more people in endemic countries to the risks of brief chemoprophylaxis. This will help protect the limbs and eyes of family members and other contacts of persons who experience(d) HD.Item Childhood Leprosy: A Prospective Observational Study from a Tertiary Care Centre of Chhattisgarh(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-03) Swain, JP; Sharma, DA; Mohankar, AD; Singh, S; Lakra, S.Childhood leprosy serves as a valuable indicator of transmission of leprosy in an area. This was a prospective observational study conducted from February 2022 to January 2024 in the Department of Dermatology Venereology and Leprosy (DVL) of Chhattisgarh Institute of Medical Sciences, a tertiary care centre of Chhattisgarh. Of the 993 new cases of leprosy seen during this period, 51 (5.13%) were of childhood leprosy in the age group 0� years. All these cases were characterized by clinical parameters and bacteriological status, their demographic and social details recorded. Most of these patients 34 (66.66%) belonged to 11� years age group, there was no child case less than 5 years of age. The male/female proportion was nearly equal. There were 26 paucibacillary cases (50.98%) and 25 multibacillary cases (49.01%). Single skin lesion was the most common presentation, observed in 43.13% of cases. Fourteen cases (27.45%) had more than 5 skin patchy lesions, followed by 2�skin lesions in 5 cases (9.8%) whereas there were 7 cases (13.7%) of nodular LL. Pure neuritic leprosy (PNL) was found in 5.8% of cases. 66.66% presented with borderline tuberculoid clinical type of leprosy. Slit skin smear positivity was observed in 19.6% of cases. Only 28/51 (54.9%) of these cases sought treatment within 1-6 months whereas 10/51 came between 7-12 months of appearance of signs/symptoms of the disease. 12 cases (23.52%) presented between 1-5 years of disease. Three cases presented with physical deformities. In 32 cases (62.74%), a history of contact with parents and siblings was there. The majority 49 (96.07%) belonged to the lower socio-economic strata, residing in rural areas 38 (74.50%) with overcrowding in 38 (74.50%) in their homes. The findings from this study can provide valuable insights for planning research cum intervention in the community for managing leprosy in general and childhood leprosy in particular in this area of Chhattisgarh.Item How Ignorance and Traditional Belief Are Affecting Treatment of Childhood Leprosy in Nigeria: A Case Study(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-06) Taiwo, O; Dairo, OG; Amole, IO; Musibau, T; Adesina, SA; Soyinka, F; Adeyanju, KO; Adegoke, AO.Childhood leprosy is an important marker of the status of the ongoing leprosy control programme, as it is an indicator of active disease transmission in the community. Multidrug therapy (MDT), when started early, can effectively prevent disease progression and permanent or progressive deformities. Ignorance and traditional beliefs remain major challenges affecting compliance with MDT. We present a case of a 4-year-old male child with leprosy whose treatment was hampered by ignorance and traditional beliefs resulting into a below- knee amputation of the left lower limb which will probably condemn the child to a life with disability. Raising awareness among people thus should continue to receive highest priority.Item Post-treatment Status of Leprosy Lesions: A Cross-sectional Study from a Tertiary Referral Centre(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-06) Anagha, KV; Sasidharanpillai, S; Babitha, V; Devi, K.Persistence of skin lesions for different time periods and disabilities after completing the schedule of prescribed treatment poses problems in convincing the patients and sometimes treating doctors about adequacy of medical treatment. This study was carried out to assess the post-treatment status of leprosy lesions in patients who received multidrug therapy (MDT) from a tertiary referral centre in Kerala, India. In this cross- sectional study, carried out from January 2020 to December 2021, we contacted the patients who completed MDT for leprosy from our institution between January 2018 and March 2020. We included those who were willing to undergo assessment of post-treatment status of leprosy lesions. The status of leprosy lesions at recruitment to study was recorded. Out of the 109 patients who completed MDT during the given period, 65 (59.6%) gave consent for re-evaluation. Fifty four out of the 65 patients (54/65, 83.1%) had sequelae of leprosy. Persistence of skin lesions was observed in 41 patients (63.05%), while residual nerve deficits were noted in 20 patients (30.7%). A complete resolution of hypopigmented lesions was observed in 15 of 40 patients (37.5%) and no resolution in 3 (7.5%). Among 14 patients with ichthyotic lesions, 3 (21.4%) showed complete resolution, 9 (64.3%) partial and 2 (14.3%) no resolution. Of the 19 patients with erythematous lesions, 5 (26.3%) had complete resolution and 14 (73.7%) partial resolution. Sensory deficits (anaesthesia or hypoaesthesia) in leprosy lesions were present in 55 of 65 patients (84.6%) at MDT initiation. Of these, 18 (32.7%) achieved complete recovery, 28 (50.9%) showed improvement, and 7 (12.7%) had no change. Twenty- three patients (23/29, 79.3%) showed persistent grade 2 disability. Two patients (2/55,3.6%) were diagnosed as relapse at re-evaluation. More than 80% of patients who were reassessed manifesting persistent leprosy lesions indicate that management of leprosy goes beyond completion of MDT. Patients were assessed and provided with appropriate counselling, including recommendations on lifestyle modifications to prevent the development of burns and trophic ulcers. Additionally, rehabilitation exercises were advised for those with deformities. For patients with existing trophic ulcers, comprehensive instructions on ulcer care and strategies to prevent secondary infections were provided. We need population-based studies among treated cases of leprosy to assess disease-related post-treatment events so as to plan future strategies.Item Investigating the Changing Landscape of Leprosy Cases and Geospatial Analysis: A Study of High and Low Endemic Districts in Maharashtra, India(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-06) Surve, S; Gitte, SV; Adkekar, R; Khera, S.Despite significant reduction in prevalence of leprosy to elimination levels, achieving Leprosy Mukt Bharat by 2027 is still a far-fetched target. This article highlights trends and of distribution of leprosy in Gadchiroli (high endemic) and Sangli (low endemic) districts in Maharashtra, India between April 1, 2016 to November 31, 2022. The geospatial analysis revealed clustering of leprosy habitats in Gadchiroli comparatively more than Sangli where urban clusters of leprosy habitats were observed. In Sangli, there was a significantly higher proportion of multibacillary cases and grade I disabilities. Additionally, there was a noticeable shift in the age distribution of newly identified cases to the 36� years age group. In Gadchiroli, an increasing proportion of cases were observed in the 9� years age group. It suggests that environmental factors, socio-economic conditions, and healthcare access can influence age-specific patterns of leprosy transmission. Hence, understanding the intricacies of age shifting in leprosy cases is essential for developing tailored interventions within high and low endemic areas.Item Current Scenario of Erythema Nodosum Leprosum: Clinico-demographic Profile of Patients Attending Dermatology Clinic at a Tertiary Care Hospital in Vadodara, Gujarat(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-06) Sangam, VB; Vara, N; Thakkar, S; Patel, N.Erythema nodosum leprosum (ENL), an inflammatory complication of leprosy continues to be important. This descriptive cross-sectional prospective observational study, conducted at a tertiary care hospital in Vadodara, Gujarat, India from December 2021 to December 2022, aimed to classify ENL using the ENLIST ENL Severity Scale (EESS). We have assessed the socio-demographic and clinical variables as well as correlated them with the severity of ENL. Sixty patients were sequentially recruited and results showed a male predominance, in age group 21-40 years, with lower education and socioeconomic status. Lepromatous leprosy and chronic ENL were most common, with a mean EESS score of 11.6. Patients were categorized into mild and moderate/ severe ENL groups based on EESS scores, where severity correlated with the extent and number of nodules. Moderate/severe cases more frequently exhibited fever, complex lesions, oedema, bone pain, arthritis, lym- phadenopathy, and neuritis, underscoring their statistically significant association with severity. Data from this study throws light on the current demographic scenario, clinical profile of ENL and evaluates its association with severity. It may aid in guiding evidence- based treatment strategies which can be tailored as per the in- dividual抯 symptomatic needs. Regular EESS assessment during follow-up appears to be important for tailored treatment strategies targeting individual symptoms.Item Transforming Lives: Understanding the Quality of Life of Leprosy Patients in Northern India(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-06) Fatima, A; Chaudhary, S; Jamil, RA; Ratnika.Leprosy also known as Hansen抯 disease, is a long-lasting infectious condition that considerably affects the quality of life of those affected. The purpose of this study is to assess the impact on quality of life of leprosy patients in a tertiary care center located in North India. 172 patients suffering from leprosy and aged 16 or over were recruited for the study, and their quality of life was measured using the Dermatology Life Quality Index (DLQI). From the data, it was found that a large section of the sample population (90.7%) noted that their quality of life has reduced with a mean DLQI score of 9.31�21. Patients suffering from lepromatous leprosy and pure neuritic types had worse quality of life estimates compared to borderline and tuberculoid leprosy patients who reported having relatively better estimates. Also, the presence of complications and the duration of illness significantly lowered the quality-of-life scores. The demographic characteristics which included age, sex, marital status and socio-economic status did not relate significantly to the DLQI scores. The study demonstrates the heterogenous burden of leprosy from physical, psychological, and social perspectives and highlights the importance of developing comprehensive care plans alongside medical attention to enhance patient outcomes.Item Probable Clofazimine Induced Lenticular Deposits Causing Cataract � A Rare Case Report(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-03) Mohanan, S; Kaliaperumal, S; Thappa, DM.Clofazimine is a red iminophenazine dye used nowadays, mainly in the treatment of leprosy. Clofazimine induced corneal, conjunctival, scleral deposition, discolouration of tears, premaculopathy and bulls eye retinopathy have all been reported in literature. However, there have been no reports of clofazimine induced cataract yet. Here we report for the first time, a patient of borderline lepromatous leprosy with clofazimine induced granular deposits in the lens, forming a posterior subcapsular cataract; and stress the need for screening for this in patients on treatment for leprosy having blurred vision.Item Understanding Leprosy in An Endemic District: Insights from a Community-Based Study(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-06) Niode, NJ; Mamuaja, EM; Kandou, RT; Adji, A; Gaspersz, S; Christopher, PM; Menaldi, SL; Widaty, S; Kartika, E; Miranda, E.Six provinces in Indonesia have yet to eliminate leprosy, with North Sulawesi among them. North Minahasa Regency reported one of the highest prevalence rates in North Sulawesi, at 1.8 per 10,000 population in 2022, with the highest concentration in the Likupang District. To meet the leprosy elimination target, comprehensive management systems must be improved to achieve a prevalence rate below 1 per 10,000 population in this district. This study was part of a community outreach program conducted by the KATAMATAKU team from Universitas Indonesia in collaboration with a team from Sam Ratulangi University. The study aimed to analyze the characteristics of leprosy patients in Likupang District, including leprosy type according to the World Health Organization (WHO), treatment status with multi-drug therapy (MDT), history of relapse, neuritis, leprosy reaction, neurotrophic ulcers, degree of disability, and other dermatoses, to serve as a reference for further research. This quantitative descriptive cross-sectional study employed purposive sampling at the Likupang Public Health Center, Likupang District, North Minahasa Regency, North Sulawesi Province. Among the suspected cases, 58 patients (72.5%) were confirmed with leprosy, predominantly males (35 patients, 60.3%) aged 20� years (44 patients, 75.9%), with a significant proportion working as farmers (13 patients, 22.4%). The most common type of leprosy was multibacillary (43 patients, 74.1%), with 54 patients (93.1%) of patients having received MDT. Of these, 31 patients (53.5%) were released from treatment, 1 patient (1,7%) experienced relapse, and 5 patients (8.6%) had discontinued treatment. Most patients did not have history of leprosy reactions (86.2%). Although the majority of patients (43 patients, 74.2%) exhibited grade 0 disability, 5 patients (8.6%) presented with grade 1 disability in the form of sensory impairment, and 10 patients (17.2%) had grade 2 disability (G2D), characterized by severe visual impairment, cortical opacity, and clawing of the fingers and toes. However, none of the patients had neurotrophic ulcers, and all were still undergoing treatment. Only four patients (6.9%) presented with concurrent dermatoses. This study revealed that leprosy remained a significant public health concern in Likupang District, with a relatively high confirmation rate among suspected cases. Although most patients completed MDT and exhibited mild disease progression, challenges such as G2D, treatment discontinuation, and relapses remained worrying. These findings underscore the need for targeted interventions to prevent disease recurrence, and to enhance and further strengthen control programs in an endemic district.Item Lepromatous Leprosy: A Rare and Unusual Presentation in the Post - Elimination Era(Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2025-03) Mishra, S; Madhual, S.Leprosy is a multi-spectrum disease ranging from tuberculoid to highly infectious lepromatous poles with varying morphology like hypopigmented to erythematous macules, papules, plaques, nodules with variable range of lesional loss of sensation. Even after elimination as a public health problem, it is still prevalent in some parts of India. The simultaneous coexistence of large erythematous plaque and multiple hypopigmented macules in lepromatous leprosy is an underreported entity till date in the previous literatures. Therefore, we are reporting a case of 43-year old male of lepromatous leprosy having normoaesthetic hypopigmented macules and the erythematous plaque, which make this case unusual.