Leprosy: definition, symptoms, causes, how to treat it

Definition of leprosy (leprosy)

Leprosy aka leprosy or Morbus Hansen's disease is a chronic contagious infection that attacks the nervous system, skin, mucous membranes of the nose, and eyes.

This skin disease is the oldest disease in the world, its appearance has been around since 600 BC. In the past, this disease was believed to be a curse from God and was often associated with sin.

Because it can cause disability, mutilation (disconnection of a limb such as a finger), ulcers and other damage, leprosy has become one of the most feared diseases, especially in ancient times.

Leprosy can be completely cured if the sufferer gets proper treatment. Patients can also return to their normal life, such as working, going to school, and doing various other activities.

In Indonesia, there are two types of leprosy that are commonly found, including:

• Basiler pope (PB). This type of leprosy is characterized by the appearance of about 1-5 white patches on the skin. The white spots that appear look very similar to tinea versicolor.
• Multi bacillary (MB). The most visible symptom of this condition is the appearance of reddish patches and accompanied by thickening of the skin similar to ringworm. These reddish spots can appear and spread more than five pieces.

How common is leprosy (leprosy)?

Every two minutes someone is diagnosed with leprosy. According to a report from the World Health Organization at the end of 2015, there were 176 thousand cases of leprosy in 138 countries including Indonesia.

Leprosy is a common disease in many countries, especially those with tropical or subtropical climates. This disease can be experienced by all people, regardless of gender or age.

Signs & symptoms of leprosy (leprosy)

In general, the most characteristic symptom of this disease is a sensation of numbness or numbness on the areas of the skin that reveal patches. This numb sensation causes the sufferer to not be able to feel the change in temperature.

As a result, those who experience this disease lose the sensation of touch and pain on their skin. This also makes sufferers feel no pain even if their fingers are cut off.

Apart from those already mentioned above, here are some other signs and symptoms of leprosy that you should be aware of.

• Dry and chipped skin.
• Areas that were previously covered with hair or hair can fall out.
• Weakness or paralysis of muscles in the hands or feet.
• Mutilation, or a sensation of numbness that causes the sufferer to be unaware when he has a wound on his body.
• A red blister or rash appears on the skin.
• Enlargement of the peripheral nerves, usually around the elbows and knees.
• A lump appears like a boil but does not hurt when touched.
• Drastic weight loss.
• Gynecomastia (enlarged breasts in men), due to hormonal imbalance.

Often times, the symptoms of this disease resemble those of other diseases, causing delays in getting the right treatment. Some diseases whose symptoms are similar to leprosy are psoriasis, tinea versicolor, ringworm, vitiligo, and many more.

When should I see a doctor?

If you think you have one or more of the symptoms of leprosy listed above, consult a doctor immediately.

Remember, everyone's bodies function differently from one another. If you are worried about certain symptoms, please consult a doctor.

Causes of leprosy

This infectious skin disease is caused by a bacterial infection of the bacillus, Mycobacterium leprae (M. leprae). BacteriaM. leprae itself reproduces very slowly and the incubation period of the disease is estimated to be about 5 years.

Until now, experts do not really understand how leprosy is spread. However, experts suspect that this disease can be transmitted by splashing the saliva of an infected person while sneezing, coughing, or talking.

The bacteria contained in this splash will enter the nose and other respiratory organs. Then, the bacteria move into the nerve cells.

Because they like places with cold temperatures, the bacteria will enter the nerve cells of the skin around the groin or scalp with lower temperatures.

The nerve cells will also become a home for bacteria to multiply. These bacteria usually take 12-14 days to divide. At this stage, an infected person does not develop leprosy symptoms.

Later, when more and more bacteria have grown, the immune system will react by removing white blood cells to fight the bacteria. Only then does the body begin to feel symptoms such as numbness in the skin.

Although it is a chronic infectious disease, some people may never get it even if they are exposed to bacteria.

This is because about 95 percent of the world's population has natural immunity against leprosy. Meanwhile, only five percent have the possibility of contracting leprosy.

Of the five percent, as many as 70 percent of people will recover on their own. Only the remaining 30 percent are really affected by leprosy and must receive medical treatment.

Those who are at risk of getting leprosy

This disease can indeed affect anyone. However, the biggest risk factor for contracting the disease is prolonged direct contact with an infected person.

Those who live in endemic areas with poor conditions, such as inadequate housing and do not have clean water sources are also at risk of developing this disease.

In addition, poor nutrition (malnutrition) and a weak immune system due to certain medical conditions such as HIV can also increase your risk of developing this disease.

Complications of leprosy

Leprosy that is left untreated or even detected late can cause physical disabilities that are temporary or permanent.

According to the National Guidelines for the Leprosy Control Program made by the Ministry of Health of the Republic of Indonesia, physical disabilities due to this disease are divided into two types, namely:

• Primary defects. Can make the sufferer numb. Primary blemishes cause skin patches like tinea versicolor which usually appear quickly and in a short time. The patches can become inflamed, swell up and cause fever. Other than that, claw hand aka bent hands and fingers can also occur.
• Secondary defect. Is an advanced stage of the primary defect, if the bacteria that have spread have caused nerve damage. The patient will experience paralysis in the hands, feet, fingers, or reduced blinking reflex. The skin can also become dry and scaly.

In addition to physical disabilities, people with this disease are also at increased risk of:

• damage to the nasal septum,
• glaucoma,
• blindness,
• erectile dysfunction, and
• kidney failure.

Diagnosis & treatment

How is leprosy diagnosed?

The first thing a doctor can do to diagnose this disease is to ask about your medical history and check your health condition thoroughly. Physical and laboratory examinations are also needed to confirm the diagnosis.

If the possibility of you suffering from leprosy is high, the doctor will perform a bacterioscopic examination. It is a procedure of taking and examining a sample of skin tissue under a microscope for the presence of bacteria M. Lepra.

Other tests include histopathology, which is a procedure with the aim of seeing tissue changes due to infection and serological examinations to determine the antibody reaction to the infection.

In bacillary pope leprosy, no bacteria will be detected. Conversely, bacteria may be found in skin smear tests from people with multi-bacillary leprosy.

Medicines for leprosy

To treat leprosy, doctors will usually perform combination drug therapy or multi-drug therapy (MDT). This treatment is generally carried out within six months to 1-2 years depending on the type of leprosy and its severity.

Some of the medicines that doctors often prescribe in doing MDT therapy include the following.

• Rifampicin. Antibiotics that work by inhibiting the growth of leprosy bacteria in the body. The medicine is in capsule form and is usually taken one hour before meals or two hours after meals. Side effects include discoloration of urine, abdominal pain, fever, and chills.
• Clofazimine. Antibiotic drugs are sometimes prescribed together with other drugs such as cortisone to treat wounds from leprosy. This medicine can be taken with food and its use must be according to a doctor's prescription so as not to worsen symptoms.
• Dapsone. A sulfone class of antibiotics, these drugs work to reduce inflammation and stop bacterial growth. The medicine is usually taken once a day or according to a doctor's prescription. Use regularly and if necessary at the same hour in order to get optimal results.

In certain cases, surgery can also be done as a follow-up process after antibiotic treatment. This surgery is performed to help repair damaged nerves or a deformed body, so that the patient can carry out normal activities as before.

Can this disease be completely cured?

Yes, leprosy can be completely cured. As long as you always remember the two main keys in the treatment of this disease, namely not being late to see a doctor and being disciplined while undergoing treatment.

In addition to preventing complications, early treatment will also prevent tissue damage in the body. Therefore, always pay attention to the condition of your body. If you start to feel symptoms of leprosy, immediately see a doctor.

After being diagnosed and getting medication, you must strictly comply with the rules given by the doctor. Take the medicine at the right time regularly and don't stop taking it without the doctor's permission.

Often forgetting to take medication or stopping medication, the bacteria will continue to multiply and become resistant. These increasingly strong bacteria can also move and infect other people's bodies easily.

In other words, the people closest to you can catch this disease at a later date if you don't regularly take medication.

Home remedies

Apart from having to take medication regularly, people with leprosy must also pay attention to their nutritional intake. This is done to help accelerate the healing of leprosy.

Below are some nutritional choices that people with leprosy should meet.

• Vitamin E. This vitamin is known to be beneficial for skin health and of course it is good for consumption by people with leprosy. You can get it from consumption of raw nuts and seeds, such as almonds, crackers, and peanuts.
• Vitamin A.This vitamin serves to maintain vision, body growth, and maintain immunity. You can get vitamin A from worter, sweet potatoes, spinach, papaya, beef liver, and dairy products and eggs.
• Vitamin D. Taking this vitamin will provide benefits for bone health and your immune system. Apart from exposure to direct sunlight, you can also get this vitamin intake from cod liver oil, salmon, sardines, mackerel, eggs, and fortified cereals with vitamin D.
• Vitamin C. Vitamin C functions in the formation of collagen and contains antioxidants that will protect you from free radicals. The content can be found in citrus fruits (oranges and lemons), mangoes, strawberries, to vegetables such as tomatoes and broccoli.
• Vitamin B. This vitamin is good for the health of the nervous system and the production of red blood cells. You can get it from eating chicken, bananas, potatoes, and mushrooms.
• Zinc. Zinc plays a role in wound healing and maintains the body's immune system. Get the benefits from consuming oysters, cheese, cashews, and oatmeal.

If you have questions, consult your doctor for the best solution to your skin problem.