By Salvatore Noto, Pieter A M Schreuder
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Additional info for Diagnosis of Leprosy
B. examined in bright sunlight. Note shadows and that lesion can hardly be identified. A. a well defined edge for part of the lesion, is apparent. It is slightly erythematous, when seen in good light, but not in sun. Appearance of lesion varies with angle of the rays of light. Tangential light is best, as on front of chin. Courtesy of Grace Warren 27 Direct sunlight passing trough the foliage of the tree creates false skin lesions! Courtesy of S Noto 28 Diagnosis of leprosy The 1st cardinal sign of leprosy Salvatore Noto, Pieter A M Schreuder Leprosy mailing list, May 2010 1 The 1st cardinal sign of leprosy “Skin patch with loss of sensation” 2 Testing for loss of sensation Courtesy of B.
Skin patch with loss of sensation; 2. enlarged peripheral nerve; 3. positive slit-skin smear. 21 The leprosy spectrum according to the Ridley and Jopling classification tuberculoid leprosy BI borderline leprosy TT BT BB -- - -, 2+, 3+ BL 3+, 4+ lepromatous leprosy LL 5+, 6+ (1+,2+) BT BB BL BI -+ = = = = = = borderline tuberculoid leprosy mid borderline leprosy borderrline lepromatous leprosy bacteriological index negative degree of positivity 22 Nerve damage in leprosy 1. dermal nerves; 2. cutaneous nerves; 3.
Leprosy Courtesy of S. Noto 4 Courtesy of S. Noto Leprosy 5 leprosy Courtesy of S. Noto 6 Leprosy Courtesy of S. Noto 7 Leprosy Courtesy of S. Noto 8 Leprosy, BL reactive after pregnancy Courtesy of B Naafs 9 Leprosy, BL reactive after pregnancy Courtesy of B Naafs 10 Leprosy, BL reactive after pregnancy Courtesy of B Naafs leprosy mailing list 11 Leprosy Courtesy of S. Noto 12 Leprosy (in reversal reaction) Courtesy of S. Noto leprosy mailing list 13 Leprosy Courtesy of S. Noto 14 Leprosy Courtesy of S.