leprosy: Diagnosis and Treatment

Since Hansen identified the bacterium that causes leprosy, diagnosis has been established by isolating the bacterium from the skin lesions or the mucous membranes of the nose and identifying it under the microscope. In 2013 a simple rapid test, using a drop of a patient's blood and some reagent, was released; developed at the Infectious Disease Research Institute, Seattle, it can detect the bacterium before symptoms develop. Duration and treatment of the disease depend upon its extent and character. Patients with nodular lesions are more difficult to treat and may succumb sooner; those with the neural type of lesion, despite possible mutilation and deformity, usually live longer and even experience spontaneous periods of subsidence of the malady. Dapsone was the drug of choice for leprosy from the 1940s until 1980, but due to drug resistance and the necessity for long-term (sometimes lifelong) treatment, it has been replaced by a combination of drugs. This combination, referred to as multiple drug therapy, has been highly effective and requires a shorter treatment period. The drug thalidomide has been approved for use against a complication of leprosy called erythema nodosum leprosum, which causes fever, skin lesions, and other symptoms.

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