Where There Is No Doctor 2011 191
LEPROSY (HANSEN’S DISEASE)
This mildly infectious disease develops slowly, often over many years. It can only
spread from persons who have untreated leprosy, to persons who have low resistance
to the disease. In areas where leprosy is common, children should be checked every
6 to 12 months—especially children living with persons who have leprosy.
Signs: Leprosy can cause a variety of skin problems, loss of feeling, and paralysis of
the hands and feet.
The first sign of leprosy is
often a slowly growing patch
on the skin that does not
itch or hurt. At first, feeling
inside the patch may be
normal. Keep watching it. If
feeling in the patch becomes
reduced or absent (see p. 38)
it is probably leprosy.
Examine the whole body for skin patches, especially the face, arms,
back, butt, and legs.
pale patch
without
clear
border
Patches are a different color from
surrounding skin, but never
completely white or scaly.
ringworm‑like patch with or
without raised border
Later signs differ according to the person’s natural resistance to the disease.
Watch out for:
• Tingling, numbness or
loss of feeling in hands
or feet. Or deformities
or loss of feeling in skin
patches.
• Slight weakness or
deformities in the hands
clawed
toes
and feet.
• Swollen nerves that form thick
cords under the skin. Nerves
may or may not be painful
when you press them.
drop foot
Check for
thick nerves in
these places.
Advanced sign may include:
burns and scars where
feeling has been lost
ear lobe
thick and
lumpy
loss of
eyebrows
blindness
nose
sometimes
deformed
painless sores on
hands or feet
paralysis
and deformity
of the hands
and feet
Treatment of leprosy: Leprosy is usually curable, but medicine must usually be taken
for years. The best medicine is dapsone, combined with 1 or 2 other medicines (see
pages 362 to 363). If a ‘lepra reaction’ (fever, a rash, pain and perhaps swelling of
hands and feet, or eye damage) occurs or gets worse while taking the medicine,
keep taking it but get medical help.