A current perspective on leprosy (Hansen's disease)

Abstract

Leprosy is a chronic granulomatous disease, which affects dermis and peripheral nerves and also can involve the eye, the mucosa of the upper respiratory tract, muscle, bone, and testes, caused by the intracellular pathogen M.leprae. Leprosy is not highly contagious. It is challenging to spread by human-to human contact unless there is consistently close–living proximity with an infected individual. The skin is not important in leprosy transmission. Bacilli are not excreted by the skin and are rarely found in the epidermis. The various clinical manifestations of leprosy are not due to different strains of M. leprae but are rather the results of the variations in the host tissue response to the bacilli in the body. There are two classification Ridley–Jopling and WHO classification. The WHO classification is useful for allocating patients to treatment groups and should be used in peripheral centers where skin smears and histopathology are not available. Leprosy causes nerve damage and permanent disabilities including blindness and paralysis. People affected by leprosy face stigma and discrimination in society. Although multidrug therapy is available, millions of people are still affected by leprosy, so new vaccine, drug and disease management approaches are urgently needed for control, prevention and treatment of this disease.