Clinical Cases in Leprosy PDF
Preview Clinical Cases in Leprosy
Clinical Cases in Dermatology Series Editor: Robert A. Norman Swetalina Pradhan Piyush Kumar Editors Clinical Cases in Leprosy Clinical Cases in Dermatology Series Editor Robert A. Norman, Tampa, FL, USA This series of concise practical guides is designed to facilitate the clinical decision- making process by reviewing a number of cases and defining the various diagnostic and management decisions open to clinicians. Each title is illustrated and diverse in scope, enabling the reader to obtain relevant clinical information regarding both standard and unusual cases in a rapid, easy to digest format. Each focuses on one disease or patient group, and includes common cases to allow readers to know they are doing things right if they follow the case guidelines. Swetalina Pradhan • Piyush Kumar Editors Clinical Cases in Leprosy Editors Swetalina Pradhan Piyush Kumar Dermatology Venereology and Leprosy Dermatology Venereology and Leprosy All India Institute of Medical Sciences Madhubani Medical College and Hospital Patna, India Bihar, India ISSN 2730-6178 ISSN 2730-6186 (electronic) Clinical Cases in Dermatology ISBN 978-3-031-08219-1 ISBN 978-3-031-08220-7 (eBook) https://doi.org/10.1007/978-3-031-08220-7 © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland To our families who generously parted with their time to allow us the privilege of working for this book. Swetalina Pradhan Piyush Kumar Preface Leprosy, a disease of the skin and peripheral nerves predominantly, is a chronic infectious disease caused by Mycobacterium leprae. If the disease is not diagnosed and treated early, peripheral neuropathy, the hallmark of leprosy, may result in various disabilities leading to social stigma and discrimination. Though leprosy has been declared an “eliminated disease” by WHO, globally there were 127,558 new lepro6sy cases detected in 2020 alone. Leprosy is largely restricted to endemic areas, but non-endemic western countries too observe occasional cases of leprosy because of migratory population. Hence, there is a need for renewed interest in research on different diagnostic and management aspects of the disease. However, there have been fewer developments in research and publications partly because of leprosy being declared an eliminated disease. The lack of vaccine combined with lack of newer more effective drugs makes early diagnosis and treatment still the most effective strategy in the management of leprosy cases. Leprosy has been a great mimicker, and often, unusual clinical presentations are encountered in clini- cal practice. Hence it is very important for clinicians to familiarize themselves with classical as well as unusual forms of leprosy and lepra reaction. The diagno- sis of leprosy is most of the times clinical, but various diagnostic tools are increas- ingly being used to diagnose the disease early in clinically doubtful cases. There have been developments in serological, molecular, electrophysiological and radio- logical techniques which can help in confirming the diagnosis of leprosy with precision. This book Clinical Cases in Leprosy has been written with an intention to docu- ment classical as well as unusual cases of leprosy seen in “post-elimination” era. The book is divided into two parts. The first part is focused on a brief overview of leprosy including clinical classification, clinical examination, investigations, treat- ment, counselling and rehabilitation. The second part discusses leprosy in a case- based manner and includes the cases that represent the wide variations in clinical features noted in leprosy. Each chapter follows a uniform pattern of description of clinical presentation, followed by differential diagnosis, investigations, final vii viii Preface diagnosis and at last, brief discussion of the case. The chapters are adequately sup- ported with clinical and histopathological photographs for better appreciation of different concepts in leprosy. We are hopeful that the book will help physicians in suspecting and diagnosing leprosy early and in a better efficient management of the cases. Patna, India Swetalina Pradhan Bihar, India Piyush Kumar Acknowledgements We express our gratitude to the authors for working tirelessly on this project and completing the chapters on time. We are grateful to our teachers for showing us the path. We thank all our patients, who kept faith in us and taught us a lot. We thank all our students, past and present: we learn more when we teach. We are thankful to the Springer staff for doing an excellent job in making this book project a success. ix Contents Part I Basics 1 Clinical Classification of Leprosy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Tanmay Padhi, Kananbala Sahu, and Swetalina Pradhan 2 Clinical Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Hemanta Kumar Kar and Mitanjali Sethy 3 Microbiological Investigations and Histopathology . . . . . . . . . . . . . . . 33 Sasi Attili, Hiral Shah, and Piyush Kumar 4 Electrophysiological and Radiological Investigations . . . . . . . . . . . . . 41 Malcolm Pinto and M. Manjunath Shenoy 5 Serological and Molecular Investigations in Leprosy . . . . . . . . . . . . . 53 Tarun Narang and Shilpa 6 Treatment of Leprosy and Lepra Reactions . . . . . . . . . . . . . . . . . . . . . 65 Santoshdev P. Rathod and Kirti Kalra 7 Counselling in Leprosy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Sunil Kumar Gupta 8 Physical Rehabilitation in Leprosy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Swetalina Pradhan and Arpita Nibedita Rout 9 Community Rehabilitation in Leprosy . . . . . . . . . . . . . . . . . . . . . . . . . 101 Neeraj Agarwal and Abhisek Mishra Part II Case Studies 10 Annular Erythematous Plaque on the Face in a Lady . . . . . . . . . . . . 113 Rajesh Kumar Mandal 11 27-Year-Old Male with Hypopigmented Patch on the Left Thigh . . . 117 Swetalina Pradhan xi
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