Leprosy without visible skin lesions

Leprosy Mailing List –  March 13^th, 2011

Ref:     Leprosy without visible skin lesions   

From:  Ganapati R., Bombay, India 

---

Dear Dr Noto,

I refer to the recent LMLs dealing with the occurrence of areas of anaesthesia caused by leprosy without visible skin lesions.  I would like to bring the following references to the knowledge of the readers: -

1)
 “A study of Mono-Neuritic Lesions  in A Leprosy Clinic”, Dongre V.V., Ganapati R., Chulawala R.G. (1976), Leprosy in India, 48 ; 132-137.  An analysis of 11,581 leprosy patients registered at the Acworth Leprosy Hospital clinic showed that 494 cases (4.3%) had primary polyneuritic leprosy and 143 (1.2%) localised cutaneous anaesthetic lesions (or non-visible anaesthetic lesions), accounting for 5.5% who had  no evidence of obvious skin lesions.

2)
 “Epidemiology of (Poly) Neuritic type of leprosy”, Noordeen SK (1972), Leprosy in India, 44: 90-96.  Noordeen prefers the term “neuritic” leprosy to denote involvement of peripheral nerve trunks as well as cutaneous nerves, if skin lesions are not clinically obvious.  His observations on the epidemiology of this type of leprosy reveal that this condition is much more common that what is generally believed and may contribute up to one-sixth (13.6%) of all cases.  Majority of the neuritic cases were found to occur over the age of 40, the 50 to 60 age group accounting for 41.9%.

Indeed it has been rightly observed by Jopling (1971)* that a prolonged polyneuritic phase may precede the appearance of skin lesions in borderlines leprosy.

*Jopling, W.H. 01(1971). In “Handbook of Leprosy”, William Hinemann Medical Books Ltd.,London , pp. 30-31.

With Regards,

Dr R Ganapati,

Director Emeritus, Bombay Leprosy Project

VN Purav Marg,

Sion-Chunabhatti, 400 022

Bombay , India