Leprosy history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
The diagnosis of leprosy should be considered when there is history of skin lesions that do not respond to treatment for more common conditions or when in presence of sensory loss with concomitant trauma or burns. Elements such as travel history, social contacts and concomitant clinical manifestations are also essential to reach a correct diagnosis.
History
Obtaining an adequate history is an essential component of the diagnosis of leprosy. Attending to the fact that it is not a common condition in developed countries, a correct diagnosis may be harder to reach, in which case a detailed history, that includes comprehensive description of symptoms, along with their time of onset and progression, as well as a list of recent travels, contacts and illnesses in any family member or coworker, is of extreme importance. Attending to the fact that the Mycobacterium leprae has a very slow growth, usually taking up to 2-10 years before symptoms start to appear, the history of travels should be emphasized and broad in time. An accurate history is also important since the clinical presentation is a major element of the diagnosis of leprosy, thereby facilitating the start of treatment, contributing to a better prognosis. History of recent trauma should also be asked, since it might explain some of the skin lesions in the patient.
Common Symptoms
Common symptoms of leprosy may include:[1]
- Reddish skin lesions, possibly with granular appearance.
- Skin lesions that are lighter than normal skin color.
- Growths in the skin.
- Thicker or dry skin.
- Numbness or lack of sensation, predominantly on the hands, arms, feet and legs.
- Muscle weakness, predominantly of the hands, feet and eyelids.
- Eye problems, such as dry eyes and corneal abrasion.
- Enlargement of nerves, followed by tenderness and/or pain, particularly on the elbow and knee areas.
- Stuffy nose.
- Nose bleed.
- Lesions of the soles of feet.
Less Common Symptoms
Less common symptoms commonly appear in more severe cases of the disease, and may include:[1]