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Vol. 104. Issue 7.
Pages 554-563 (September 2013)
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Vol. 104. Issue 7.
Pages 554-563 (September 2013)
Review
DOI: 10.1016/j.adengl.2012.03.028
Leprosy. An Update: Definition, Pathogenesis, Classification, Diagnosis, and Treatment
Lepra: Puesta al día. Definición, patogénesis, clasificación, diagnóstico y tratamiento
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K. Eichelmann??
Corresponding author
eichelmannk@gmail.com

Corresponding author.
, S.E. González González, J.C. Salas-Alanis, J. Ocampo-Candiani
Servicio de Dermatología, Hospital Universitario José Eleuterio González, Monterrey Nuevo León, Mexico
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Table 1. The WHO's Cardinal Signs for the Clinical Diagnosis, Classification, and Treatment of Leprosy.
Table 2. Treatment Stipulated by the World Health Organization.
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Abstract

Leprosy is a chronic granulomatous disease caused by the bacillus Mycobacterium leprae. It primarily affects the skin and peripheral nerves and is still endemic in various regions of the world. Clinical presentation depends on the patient's immune status at the time of infection and during the course of the disease. Leprosy is associated with disability and marginalization.

Diagnosis is clinical and is made when the patient has at least 1 of the following cardinal signs specified by the World Health Organization: hypopigmented or erythematous macules with sensory loss; thickened peripheral nerves; or positive acid-fast skin smear or skin biopsy with loss of adnexa at affected sites.

Leprosy is treated with a multidrug combination of rifampicin, clofazimine, and dapsone. Two main regimens are used depending on whether the patient has paucibacillary or multibacillary disease.

Keywords:
Leprosy
Paucibacillary
Multibacillary
Multidrug therapy
Hansen disease
Mycobacteria leprae
Disability
Smear test
Resumen

La lepra es una enfermedad granulomatosa crónica causado por una micobacteria (M. leprae) que presenta predisposición por la piel y nervios periféricos. La lepra continúa siendo endémica en distintas regiones del mundo. La presentación clínica de la enfermedad depende del estado inmunológico del paciente al adquirirla y durante la evolución de la misma. Es una infección que se asocia a discapacidad y marginación.

El diagnóstico de lepra es clínico y se hace al tener uno o más de los signos cardinales establecidos por la OMS; máculas hipopigmentadas o eritematosas con disminución de la sensibilidad, engrosamiento de los nervios periféricos y la demostración de bacilos ácido alcohol resistente en una baciloscopia o biopsia de piel, con pérdida de anexos en los sitios afectados.

El tratamiento es con tres drogas; rifampicina, clofazimina y dapsona. Existen principalmente dos modalidades de tratamiento dependiendo de la presentación clínica del paciente como paucibacilar o multibacilar.

Palabras clave:
Lepra
Paucibacilar
Multibacilar
Multiterapia
Enfermedad de Hansen
M. leprae
Discapacidad
Baciloscopia

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