|
How is it diagnosed
Based on presence of any one of the following Cardinal signs.
|
Sr.
No
|
Cardinal Signs |
Method of Eliciting |
| 1 |
Hypopigmented or reddish
Skin lesion(s) with definite loss of sensation
|
Anaesthesia on the patch to be elicited by testing
for touch, pain and temp. sensation |
| 2 |
Thickening of peripheral nerves with loss of sensation
and weakness of the muscles of the hands, feet or face |
Examination of peripheral nerves e.g 1)Greater
Auricular 2) Radial.3) Ulnar 4) Median 5) Lateral Popliteal
6) Posterior Tibial etc. |
| 3 |
Demonstration of Mycobacterium Leprae (M.leprae)
in the lesions |
Acid fast staining and examination Under oil immersion
microscope |
The first two cardinal signs can be identified by clinical examination
alone while the third by examination of the slit skin smear under
the microscope. Bacteriological examination has been discontinued
in the programme.
PRE-REQUISITES OF GOOD CLINICAL EXAMINATION
 |
Assurance & counseling of patients and/or
family. |
|
Essentially in good daylight. |
|
Exam. of whole body with courtesy & respect
to patient's privacy. |
|
Examination of female patient as far as possible
by a female doctor or at least in the presence of one female. |
CLINCAL EXAMINATION
|
The location of skin lesions be marked on a simple
body outline. |
|
One or few typical skin lesions should be tested
for loss of sensation. |
|
The main peripheral nerve trunks should be palpated
to certain any thickening and tenderness. |
|
Eyes, hands and feet should be examined.
|
Field classification of leprosy for purpose of MDT
| Clinical manifestation |
PB (pauci-bacilli) |
MB (Multi bacillary |
| skin lesion |
upto 5 lesion |
6 and above |
| Nerve involvement |
no nerve involvement or only one
nerve involvement |
more than one nerve trunk involvement |
|
