Leprosy Mailing List – August 15, 2014
Ref.: (LML) WHO disability grading and the term anaesthesia
From: Grace Warren, Sidney, Australia
Dear Pieter,
Thank you for publishing Dr Rao's paper. I must accent his comments re the altered sensory perception. There are hundreds of patients out there who have altered perception but not anaesthesia but according to WHO do not have leprosy. However, a careful examination and slit skin smear can confirm the diagnosis in many cases.
Is there any way of getting the WHO to modify their statement??? As I know of many patients who to me have definite leprosy but are deprived of treatment because they do not full fill the WHO definition.
The other fact, often missed, is that all patients need definite skin patches according to WHO criteria. In S E Asia there are many patients with primary persistent neuritic leprosy. They present with a paralysis or anaesthetic area but no skin patch ever! I saw a young man with a clawed hand told by a WHO Consultant in Cambodia that he did not have leprosy!!! I knew otherwise and just palpate his nerves. I know of patients who did not receive treatment and continue to slowly progress. We will treat such persons, but in many countries treatment is not available as they are not officially leprosy.
Grace Warren
Previously Adviser in Leprosy and reconstructive surgery
for The Leprosy Mission in Asia ( 1975-1995).
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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