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Leprosy: the disease


            
             Few diseases have been so misunderstood. Since pre-Biblical times, the leprosy patient has been surrounded by myth, superstition, fear, apathy and rejection. In most instances the unfortunate individual was faced not only with a totally debilitating and deforming disease, but also with dire social and psychological consequences as well. He or she suffered social ostracism, inability to work, forced separation from family, and had virtually no hope of cure or return to normalcy. As a result, many of them simply disappeared. The victims, often believing they "were being punished for their sins" became despondent, apathetic and resigned to fate.
             Dr. Armauer Hansen of Norway was the first to see the leprosy germ under a microscope. This was 1873, and Hansen's discovery was revolutionary. The evidence was clear for all the world: leprosy is caused by a germ (Mycobacterium leprae). It was not hereditary, a curse, or from sin. Because of Dr. Hansen's work, leprosy is also called Hansen's Disease.
             This disease is a chronic infectious disease usually affects the skin and peripheral nerves but has a wide range of possible clinical manifestations. Patients are classified as having paucibacillary or multibacillary Hansen's disease. Paucibacillary Hansen's disease is milder and characterized by one or more hypopigmented skin macules. Multibacillary Hansen's disease is associated with symmetric skin lesions, nodules, plaques, thickened dermis, and frequent involvement of the nasal mucosa resulting in nasal congestion and epistaxis.
             Microbiology of Mycobacterium leprae.
             The aetiological agent of leprosy is Mycobacterium leprae. It is a strongly acid-fast rod-shaped organism with parallel sides and rounded ends. In size and shape it closely resembles the tubercle bacillus. It occurs in large numbers in the lesions of lepromatous leprosy, chiefly in masses within the lepra cells, often grouped together like bundles of cigars or arranged in a palisade.


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