Hansen's disease

Hansen's disease

Introduction

Leprosy is still prevalent in tropical regions of Africa, Asia, Oceania and Latin America. It affects 10 to 12 million people, more than half have no access to a system of care. It is an endemic disease. However, leprosy has almost disappeared from Western Europe since the late fifteenth century. For cases currently seen in developed countries, the contamination occurred during a prolonged stay in an area where polio still exists.

Causes of the Disease

The main factor that causes the disease are Bacteria, rod-shaped, Hansen's bacillus, or Mycobacterium leprae. Contagion is possible only in certain forms of leprosy (lepromatous leprosy) and is conducted from nasal secretions or cutaneous wounds of a patient who contaminates the skin (the soles of bare feet) or mucous membranes (respiratory mucosa) of a healthy subject. It is low or negligible in developed countries, but is favored by poor sanitary conditions and the heat in tropical countries (Kulkarni, 2008, 90-123).

Symptoms and Signs

The evolution of leprosy is very slow and continues for several years. After an incubation period of one to five years, the disease begins as a form called indefinite. The earliest lesions are small-depigmented spots, usually white, a few millimeters, where the skin is insensitive and does not sweat. The disease is then called a tuberculoid form, a form known as lepromatous, or an intermediate form.

The tuberculoid leprosy, the most common, occurs in patients with immune relatively effective. It affects especially the nerves, which increase in volume, especially in regions of the elbow, leg and neck and become palpable as a regular or large beads interspersed with bulges and constrictions. The evolution is towards an extension of the lesions, a progressive drying of the skin, alterations of the muscles and nerves resulting in plantar ulcers (ulcers), contractures of tendons and fascia of the feet and hands.

The lepromatous leprosy, the most severe, occurs in patients with immune system very weak. It results in the appearance of lepromas, red-brown nodules painful, which protrude under the skin and are sufficiently numerous and large to be mutilated face, when reached such lesions, is said leonine (reminiscent of a lion). Lepromas to join a highly contagious inflammatory rhinitis can lead to a collapse of cartilage, damage to eyes, mouth and intestines, fever and a major general fatigue (Sasaki, 2001, 729-36).

Diagnostic Diagnosis

The infection is highlighted by a skin test specific (lepromin), the Mitsuda reaction in subjects suffering from tuberculoid leprosy, and a biopsy of skin lesions or by examination of a nasal smear, revealing many of Hansen bacilli in persons suffering from lepromatous.

Treatment

Leprosy is treated by administration of sulfones, however, many resistance to this drug being developed in recent years, it currently uses for other products (sulfonamides, rifampin, clofazimine). Treatment must be continued very long, from 6 months to 2 years or more in advanced forms. It heals and prevents the early forms of severe evolution.

Evolution

Leprosy is a disease very mutilating can leave scars after healing of ...