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Review
. 2014 Mar-Apr;89(2):205-18.
doi: 10.1590/abd1806-4841.20142450.

Leprosy: review of the epidemiological, clinical, and etiopathogenic aspects - part 1

Joel Carlos Lastória  1 , Marilda Aparecida Milanez Morgado de Abreu  2
Affiliations
Review

Leprosy: review of the epidemiological, clinical, and etiopathogenic aspects - part 1

Joel Carlos Lastória et al. An Bras Dermatol. 2014 Mar-Apr.

Abstract

Leprosy is caused by Mycobacterium leprae and has been known since biblical times. It is still endemic in many regions of the world and a public health problem in Brazil. The prevalence rate in 2011 reached 1.54 cases per 10,000 inhabitants in Brazil. The mechanism of transmission of leprosy consists of prolonged close contact between susceptible and genetically predisposed individuals and untreated multibacillary patients. Transmission occurs through inhalation of bacilli present in upper airway secretion. The nasal mucosa is the main entry or exit route of M. leprae. The deeper understanding of the structural and biological characteristics of M. leprae, the sequencing of its genome, along with the advances in understanding the mechanisms of host immune response against the bacilli, dependent on genetic susceptibility, have contributed to the understanding of the pathogenesis, variations in the clinical characteristics, and progression of the disease. This article aims to update dermatologist on epidemiological, clinical, and etiopathogenic leprosy aspects.

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Conflict of interest statement

Conflict of Interest: None.

Figures

FIGURE 1
FIGURE 1
Indeterminate leprosy: hypochromic spots with indefinite borders on the face
FIGURE 2
FIGURE 2
Tuberculoid leprosy: well-defined annular erythematous plaque on the dorsum of the hand
FIGURE 3
FIGURE 3
Lepromatous leprosy: dry and barely discernible hypochromic spots on the arm
FIGURE 4
FIGURE 4
Lepromatous leprosy: ichthyosiform appearance of the skin of the legs and lepromas
FIGURE 5
FIGURE 5
Lepromatous leprosy: infiltrated face and madarosis
FIGURE 6
FIGURE 6
Borderline leprosy: polymorphic appearance of the lesions
FIGURE 7
FIGURE 7
Borderline leprosy: brownish erythematous plaques (foveal spots) in the trunk
FIGURE 8
FIGURE 8
Borderline leprosy: several erythematous plaques with clear inner borders and indefinite outer borders in the trunk
FIGURE 9
FIGURE 9
Type 1 reaction: erythematosus plaque on the face
FIGURE 10
FIGURE 10
Erythema nodosum leprosum: inflammatory nodules in the upper limb
See this image and copyright information in PMC

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