Clinical study to relook into the case definition and treatment of leprosy

Abstract

Introduction: The statistical elimination of leprosy in India is something to cheer about but the steady appearance of newer cases still haunt us. It is sad to note that countries with high prevalence of Leprosy administer once a month of rifampicin while developed nations administer daily rifampicin. Materials and Methods: We have done a retrospective analysis of all the leprosy cases seen in the department of Dermatology, Belagavi Institute of Medical Sciences, India. A total of 64 cases were analyzed using the case records and various parameters were recorded. Results: Out of 64 cases, 13 were treated as out patients and 51 were treated as in patients. The most common age group was 21-40. Males outnumbered the females. There were 62 cases of multibacillary and only 2 cases of paucibacillary. Of 64, 30 were newly detected, 19 were receiving treatment and 15 cases had completed treatment but had one or more complications. Family h/o leprosy was noted in 4.The most common presenting complaints were: Multiple painful, reddish raised skin lesions – 24; Spontaneous blisters/Ulcers on the hand/feet – 21; Hypopigmented patches – 13. As per the clinical criteria of WHO, only 37 patients had anaesthetic patches, 52 had nerve thickening and only 11 demonstrated bacilli in the slit skin smear. Discussion: A good number of patients are being seen with lepra reactions or complications. Conclusions: It is quite evident that the presentation of leprosy is changing. This is a paradigm shift in the initial presentation and needs a relook into the existing diagnostic criteria. Keywords: Leprosy, Multidrug therapy, Leprosy elimination.