Leprosy: A Practical Guide

Leprosy (Hansen’s disease) is an infectious disease caused by Mycobacterium leprae. It is one of the most disabling disorders in developing countries, with a peak incidence in the tropics and subtropics. With globalization, leprosy is now increasingly spreading to the western world. The impact of this infectious disorder is relevant for the human community due to its transmissible nature, and also important for the individual because of its debilitating consequences. Leprosy is a multifaceted systemic disease with variable presentation and clinical picture. Its identification may therefore not be straightforward, especially outside endemic areas. During its chronic course, leprosy is characterized by acute phases during which there may be exacerbation of symptoms and rapid progression of damage. When leprosy affects the eyes, nerves, and kidneys, it can represent a true medical emergency. The aim of this book is to make the reader familiar with the characteristic signs of disease, including abnormalities of the skin, nerves, eyes, hands, feet, testes, and bone. Early identification of the disease is critical to prevent patient disability and establish appropriate therapy. Emphasis will be given to the current diagnostic tools to identify and quantify the organ damage, including electrophysiology, ultrasonography, magnetic resonance imaging, laboratory tests, and histopathology. Specific topics such as leprosy and pregnancy, leprosy and HIV infection, epidemiology, and leprosy control will also be covered.

In this book, the reader is guided through a modern diagnostic work-up and classification of leprosy, with discussion of the results of physical examination (interpretation of the primary skin lesion and clinical features of peripheral neuropathies), laboratory data, and histopathologic and imaging investigations. This combined approach allows planning of an integrated therapeutic strategy with the aim of killing the Mycobacterium leprae and preventing the acute phases of the disease.

The book is designed for practical use and has been divided into eight easily accessible sections covering all relevant topics related to leprosy. These sections are written by renowned leprosy experts from different specialties, including dermatologists, neurologists, radiologists, neurosurgeons, and microbiologists. There is specific focus on the two organs most often involved by leprosy – the skin and nerves. Up-to-date leprosy statistics have been also reported at the end of the book.