Leprosy: A clinical review

Authors

  • Andréia P. Gomes Departmento de Medicina e Enfermagem. Universidade Federal de Viçosa. Viçosa, Minas Gerais, Brasil.
  • Paulo Sérgio B. Miguel Instituto Federal de Educação, Ciência e Tecnologia de Roraima. Boa Vista, Roraima, Brasil.
  • Francisca B. Martins e Mafra Departmento de Medicina e Enfermagem. Universidade Federal de Viçosa. Viçosa, Minas Gerais, Brasil.
  • Ana Cláudia L. de Moura Faculdade Dinâmica do Vale do Piranga. Ponte Nova, Minas Gerais, Brasil.
  • Luciene M. Braga Departamento de Medicina e Enfermagem. Universidade Federal de Viçosa. Viçosa, Minas Gerais, Brasil.

DOI:

https://doi.org/10.12957/bjhbs.2021.63968

Keywords:

Mycobacterium leprae, Leprosy, Epidemiology.

Abstract

Leprosy is a chronic infectious disease, caused by Mycobacterium
leprae. It has great historical importance and is responsible for
high rates of infected people all over the world, Brazil being
the second country in number of cases, only behind India.
The clinical manifestations of the disease depend on the host’s
immune response, and it has the potential to affect practically
all organs and systems, although it mainly affects the skin and
peripheral nerves, and may, above all, present periods of aggravation,
which are called reactions. Thus, it is characterized as a
disease of incapacitating character, which can bring irreparable
physical deformities, presenting a great impact on the physical,
social, and mental health of the patient. In this review we discuss
the main aspects involving the condition of neglected disease,
especially the epidemiology, classifications, clinical picture,
complications, diagnosis, treatment, and care for prevention.

Author Biographies

Andréia P. Gomes, Departmento de Medicina e Enfermagem. Universidade Federal de Viçosa. Viçosa, Minas Gerais, Brasil.

Departmento de Medicina e Enfermagem. Universidade Federal de
Viçosa. Viçosa, Minas Gerais, Brasil.

Paulo Sérgio B. Miguel, Instituto Federal de Educação, Ciência e Tecnologia de Roraima. Boa Vista, Roraima, Brasil.

Instituto Federal de Educação, Ciência e Tecnologia de Roraima.
Boa Vista, Roraima, Brasil.

Francisca B. Martins e Mafra, Departmento de Medicina e Enfermagem. Universidade Federal de Viçosa. Viçosa, Minas Gerais, Brasil.

Departmento de Medicina e Enfermagem. Universidade Federal de
Viçosa. Viçosa, Minas Gerais, Brasil.

Ana Cláudia L. de Moura, Faculdade Dinâmica do Vale do Piranga. Ponte Nova, Minas Gerais, Brasil.

Faculdade Dinâmica do Vale do Piranga. Ponte Nova, Minas Gerais,
Brasil.

Luciene M. Braga, Departamento de Medicina e Enfermagem. Universidade Federal de Viçosa. Viçosa, Minas Gerais, Brasil.

Departamento de Medicina e Enfermagem. Universidade Federal de
Viçosa. Viçosa, Minas Gerais, Brasil.

References

Hess S, Rambukkana A. Cell biology of intracellular adaptation of Mycobacterium leprae in the peripheral nervous system. Bacteria and Intracellularity. 2020:227-245. https://doi.org/10.1128/microbiolspec.BAI-0020-2019.

Arif T, Dorjay K, Adil M, et al. Classification of leprosy-From past to present. Journal of Pakistan Association of Dermatology. 2018; 28(1):95-99.

Sarode G, Sarode S, Anand R, et al. Epidemiological aspects of leprosy. Disease-a-Month, 2020: 100899. https://doi.org/10.1016/j.disamonth.2019.100899

Tió-Coma M, Wijnands T, Pierneef L, et al. Detection of Mycobacterium leprae DNA in soil: multiple needles in the haystack. Scientific reports. 2019;9(1):1-7. https://doi.org/10.1038/s41598-019-39746-6

Steinmann P, Dusenbury C, Addiss D, et al. A comprehensive research agenda for zero leprosy. Infectious Diseases of Poverty. 2020;9(1):1-7. https://doi.org/10.1186/s40249-020-00774-4.

Pedelacq JD, Nguyen MC, Terwilliger TC, et al. A Comprehensive Review on Mycobacterium tuberculosis Targets and Drug Development from a Structural Perspective. Structural Biology in Drug Discovery: Methods, Techniques, and Practices. 2020:545-566. DOI: 10.1002/9781118681121.ch23

Maymone MB, Laughter M, Venkatesh S, et al. Leprosy: Clinical Aspects and Diagnostic Techniques. Journal of the American Academy of Dermatology. 2020;83:1-13. https://doi.org/10.1016/j.jaad.2019.12.080

Shepard CC. The experimental disease that follows the injection of human leprosy bacilli into footpads of mice. Journal of Experimental Medicine. 1960;112(3):445–54. https://doi.org/10.1084/jem.112.3.445

Sharma R, Singh P, McCoy RC, et al. Isolation of Mycobacterium lepromatosis and Development of Molecular Diagnostic Assays to Distinguish Mycobacterium leprae and M. lepromatosis. Clinical Infectious Diseases. 2020;71(8):e262-e269. https://doi.org/10.1093/cid/ciz1121

Avanzi C, Singh P, Truman RW, et al. Molecular epidemiology of leprosy: An update. Infection, Genetics and Evolution, 2020:104581. https://doi.org/10.1016/j.meegid.2020.104581

Bhandari J, Awais M, Gupta V. Leprosy (Hansen Disease). StatPearls [Internet]. 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559307/

Reibel F, Cambau E, Aubry A. Update on the epidemiology, diagnosis, and treatment of leprosy. Med Mal Infect. 2015;45:383-93. https://doi.org/10.1016/j.medmal.2015.09.002

Grayson, W. An update on cutaneous infections. Diagnostic

Histopathology. 2020;26(3):107-113. https://doi.org/10.1016/j.

mpdhp.2019.12.002

Mathema B, Kurepina NE, Bifani PJ, et al. Molecular

epidemiology of tuberculosis: current insights. Clinical

microbiology reviews. 2006;19(4), 658-685. https://doi.

org/10.1128/CMR.00061-05

Das M, Diana D, Wedderburn A, et al. Molecular epidemiology

and transmission dynamics of leprosy among multicase

families and case-contact pairs. International Journal

of Infectious Diseases. 2020;96:172-179. https://doi.

org/10.1016/j.ijid.2020.04.064

Brasil. Ministério da Saúde. Guia de Vigilância em Saúde 3. ed.

Brasília. 2019; p 294-325.

White C, Franco-Paredes C. Leprosy in the 21st century.

Clinical Microbiology Reviews. 2015;28(1):80-94. https://doi.

org/10.1128/CMR.00079-13

Truman R, Singh P, Sharma R, et al. Probable Zoonotic Leprosy

in the Southern United States. N Engl J. Med. 2011;364:1626–

DOI: 10.1128/CMR.00079-13

Chavarro-Portillo B, Soto CY, Guerrero MI. Mycobacterium

leprae’s evolution and environmental adaptation. Acta

Tropica. 2019;197:105041. https://doi.org/10.1016/j.

actatropica.2019.105041.

Bratschi MW, Steinmann P, Wickenden A, et al. Current

knowledge on Mycobacterium leprae transmission: a systematic

literature review. Leprosy Review. 2015;86(2):142-55.

World Health Organization. Global Leprosy Strategy 2016-

: Accelerating towards a world without leprosy. Geneva:

WHO/SEARO, 2016. 36 p.

World Health Organization. Weekly epidemiological record.

30 Aug; 94(35/36):389:412.

Benjak A, Avanzi C, Benito Y, et al. Highly reduced genome of

the new species Mycobacterium uberis, the causative agent

of nodular thelitis and tuberculoid scrotitis in livestock and a

close relative of the leprosy bacilli. MSphere. 2018;3(5):1-11.

1128/mSphere.00405-18

Lyon S, Grossi MAF. Leprosy. Rio de Janeiro: Medbook, 2013.

Ridley DS, Jopling WH. Classification of leprosy according to

immunity. A five group system. International Journal of Leprosy.

;34:255-273.

Lastória JC, Abreu MAMMD. Leprosy: review of the

epidemiological, clinical, and etiopathogenic aspects-part 1.

Anais Brasileiros de Dermatologia. 2014;89(2):205-218. https://

doi.org/10.1590/abd1806-4841.20142450

Brandão LSG, Marques GF, Barreto JA, et al. Tuberculoid

leprosy presenting as a “racket” lesion. Anais Brasileiros

de Dermatologia. 2015;90(3):420-422. 10.1590/abd1806-

20153401

Rodrigues ACS, Quintella DC, Rodrigues FT, et al.

Lepromatous Leprosy: Report of a Case of the Histiocytic-

Symile Type. Journal of the Portuguese Society of Dermatology

and Venereology. 2019;77(1):73-76. https://doi.org/10.1186/

s42047-019-0051-x

Kumar B, Uprety S, Dogra S. Clinical diagnosis of leprosy.

International Textbook of Leprosy. 2017. 24p. Disponível em:

https://www.internationaltextbookofleprosy.org/sites/default/

files/ITL_2_1%20FINAL_1.pdf

World Health Organization. Expert committee on leprosy. World

Health Organ Tech Rep Ser. 1998;874:1-43.

Santos DFD, Mendonça MR, Antunes DE, et al. Revisiting

primary neural leprosy: clinical, serological, molecular,

and neurophysiological aspects. PLoS Negl Trop Dis.

;11(11):e0006086. https://doi.org/10.1371/journal.pntd.0006086

Freitas RCSD, Pereira CAZ, Muri NT, et al. Primary neural

leprosy mimicking rheumatological disorders. Revista da

Associação Médica Brasileira. 2019;65(6):767-770.

https://doi.org/10.1590/1806-9282.65.6.767

Cohens JM. Hanseníase ocular: uma abordagem histórica.

Arquivos Brasileiros de Oftalmologia. 2009;72(5):728-33.

https://doi.org/10.1590/S0004-27492009000500027

Araújo AERA, Aquino DMC, Goulart IMB, et al. Complicações

neurais e incapacidades em hanseníase em capital do

nordeste brasileiro com alta endemicidade. Revista

Brasileira de Epidemiologia. 2014;17(4):899-910. https://doi.

org/10.1590/1809-4503201400040009

Azulay RD, Azulay DR, Azulay-Abulafia L. Dermatology. Rio de

Janeiro: Ed. 2017.

Antunes DE, Goulart IMB, Goulart LR. Will cases of leprosy

reaction increase with COVID-19 infection. PLoS neglected

tropical diseases. 2020;14(7), e0008460. https://doi.

org/10.1371/journal.pntd.0008460

Akpolat ND, Akkus A, Kaynak E. An update on the

epidemiology, diagnosis and treatment of leprosy. In: Hansen’s

Disease-The Forgotten and Neglected Disease. IntechOpen,

Disponível em: https://www.intechopen.com/books/

hansen-s-disease-the-forgotten-and-neglected-disease/

an-update-on-the-epidemiology-diagnosis-and-treatment-ofleprosy.

https://doi.org/10.5772/intechopen.80557

Brasil. Ministério da Saúde. Guia Prático em hanseníase. 1. ed.

Brasília, 2017.

World Health Organization. Weekly Epidemiological Record.

;96:01-02.

Lyon S, Grossi, MAF. Diagnosis and treatment of leprosy. In:

Leprosy advances and challenges. 2014; p.141-169.

Narang T, Bishnoi A, Dogra S, et al. Alternate Anti-Leprosy

Regimen for Multidrug Therapy Refractory Leprosy: A

Retrospective Study from a Tertiary Care Center in North

India, The American Journal of Tropical Medicine and Hygiene.

;100(1):24-30. https://doi.org/10.4269/ajtmh.18-0256

Brasil. Coordenação de Monitoramento e Avaliação de

Tecnologias em Saúde – CMATS/CGGTS/DGITIS/SCTIE/MS.

Relatório de recomendação de medicamento no. 583. Ampliação

de uso da claritromicina para o tratamento de pacientes com

hanseníase resistente a medicamentos. Brasília, 2020.

Bhandari J, Awais M, Robbins BA, et al. Leprosy. [Updated

Jun 7]. In: StatPearls [Internet]. Treasure Island (FL):

StatPearls Publishing; 2021 Jan. Available from: https://www.

ncbi.nlm.nih.gov/books/NBK559307/

Sarkar T, Sarkar S, Patra AC, et al. BCG vaccination: Effects on

the patterns of pediatric leprosy. J Family Med Prim Care. 2020 Jul

;9(7):3673-3676. https://doi.org/10.4103/jfmpc.jfmpc_478_20

Smith CM, Smith WC. Chemoprophylaxis is effective in the

prevention of leprosy in endemic countries: a systematic review

and meta-analysis. MILEP2 Study Group. Mucosal Immunology

of Leprosy. Journal of Infect. 2000;41(2):137-42. https://doi.

org/10.1053/jinf.2000.0698.

Schoenmakers A, Mieras L, Budiawan T, et al. The State of Affairs

in Post-Exposure Leprosy Prevention: A Descriptive Meta-

Analysis on Immuno- and Chemo-Prophylaxis. Res Rep Trop

Med. 2020;11:97-117. https://doi.org/10.2147/RRTM.S190300

Richardus R, Alam K, Kundu K, et al. Effectiveness of singledose

rifampicin after BCG vaccination to prevent leprosy

in close contacts of patients with newly diagnosed leprosy:

A cluster randomized controlled trial. Int J Infect Dis. 2019

Nov;88:65-72. https://doi.org/10.1016/j.ijid.2019.08.035.

Setia MS, Steinmaus C, Ho CS, et al. The role of BCG in

prevention of leprosy: a meta-analysis. Lancet Infectious

Diseases. 2006;6(3):162-70. DOI: https://doi.org/10.1016/

S1473-3099(06)70412-1

Mungroo MR, Khan NA, Siddiqui R. Mycobacterium leprae:

Pathogenesis, diagnosis, and treatment options. Microbial

Pathogenesis. 2020;104475. https://doi.org/10.1016/j.

micpath.2020.104475

Downloads

Published

2022-03-04

How to Cite

Gomes, A. P., Miguel, P. S. B., Martins e Mafra, F. B., de Moura, A. C. L., & Braga, L. M. (2022). Leprosy: A clinical review. Brazilian Journal of Health and Biomedical Sciences, 20(2), 151–160. https://doi.org/10.12957/bjhbs.2021.63968

Issue

Section

Literature Review