Musculoskeletal manifestations in leprosy

Abstract

Leprosy, a chronic infectious disease caused by Mycobacterium leprae and Mycobacterium lepromatosis, primarily targets the skin and peripheral nerves, frequently leading to dermatological, neurological, and musculoskeletal complications. This review highlights the spectrum of musculoskeletal manifestations in leprosy, including acute arthritis during Type 2 reactions, chronic arthritis mimicking autoimmune diseases like rheumatoid arthritis, and neuropathic arthropathy. These manifestations underscore the complex interplay of inflammatory and immune mechanisms. Acute arthritis often involves both small and large joints, while chronic forms may present diagnostic challenges due to their resemblance to other inflammatory arthritides. Clinical management centers on multidrug therapy (MDT) for infection control, complemented by immunosuppressive or anti-inflammatory agents for reactional episodes. Recent advancements, such as biologics and synthetic immunosuppressants, have demonstrated efficacy in refractory cases, offering new therapeutic avenues. Heightened clinician awareness is essential for timely diagnosis and integrated management, particularly in endemic regions, to mitigate long-term disabilities and improve patient outcomes.

Keywords: Chronic arthritis; Leprosy; Leprosy reactions; Neuropathic arthropathy.