Patient’s Data

1. Indeterminate Leprosy • Patient’s Data • Earliest and mildest form • One to a few of hypopigmented or erythematousmacules • Loss of sensation is rare • 75% of affected persons have lesions that heal spontaneously • Most cases progress into a later form, although patients with strong immunity may either clear the infection on their own or persist in this form without progressing. • erythematous ill-defined asymptomatic patches (upper extremities, with tingling sensation, numbness of the hands) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs) • (+) leonine facies • (-) madarosis

3. Tuberculoid Leprosy • Patient’s Data • One erythematous large plaque with well-defined borders that are elevated and that slope down into an atrophic center • Lesions can become arciform or annular • Can be found on the face, limbs, or elsewhere, but they spare intertriginous areas and the scalp • Lesions can be dry and scaly, hypohidrotic, and hairless • Involves a large, asymmetric hypopigmentedmacule • erythematous ill-defined asymptomatic patches (upper extremities, with tingling sensation, numbness of the hands) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs) • (+) leonine facies • (-) madarosis

4. Tuberculoid Leprosy • Patient’s Data • Spontaneous resolution can occur in a few years, leaving pigmentary disturbances or scars • Progression can also occur, leading to borderline-type leprosy • Neural involvement is common - leads to tender, thickened nerves with subsequent loss of function • Great auricular nerve, common peroneal, ulnar, and radial cutaneous and posterior tibial nerves are often prominent • Nerve damage can happen early, resulting in wrist drop or foot drop • erythematous ill-defined asymptomatic patches (upper extremities, with tingling sensation, numbness of the hands) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs) • (+) leonine facies • (-) madarosis

5. Tuberculoid Leprosy

6. Borderline Tuberculoid • Patient’s Data • Similar to tuberculoid type except that lesions are smaller and more numerous • Alopecia is less • Anesthesis is less severe • Disease may stay in this stage or convert back to tuberculoid form, or progress to lepromatous leprosy • erythematous ill-defined asymptomatic patches (upper extremities, with tingling sensation, numbness of the hands) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs) • (+) leonine facies • (-) madarosis

7. Borderline Tuberculoid Leprosy

8. References http://dermnetnz.org/bacterial/leprosy.html http://emedicine.medscape.com/article/1104977-overview