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Textbook of Clinical Leprosy
Virendra N Sehgal
CHAPTER 1:
Mycobacterium Leprae
LEPROMIN TEST
SIGNIFICANCE OF LEPROMIN TEST
CHAPTER 2:
Epidemiology of Leprosy
GLOBAL DISTRIBUTION
DISTRIBUTION IN INDIA
CHANGING SCENARIO
Reservoir of Infection
Transmission
Portal of Entry
Incubation Period
AGE AT ONSET
SEX PREVALENCE
FAMILY INCIDENCE
INDIVIDUAL FACTORS
Climate
Race
Diet
CHAPTER 3:
Pathogenesis, Pathology and Evolution of Classification
INDETERMINATE LEPROSY
LEPROMATOUS LEPROSY
Histoid Leprosy
Tuberculoid Leprosy
BORDERLINE LEPROSY
CHAPTER 4:
Immunology of Leprosy
LEPROMIN TEST
EPICUTANEOUS SENSITIZATION TO DINITROCHLOROBENZENE (DNCB)
T Lymphocytes and its Subsets in Peripheral Blood
T Lymphocytes and Subsets in Leprosy Lesion
Macrophages
Interleukins
B-Lymphocytes in Peripheral Blood
Serum Immunoglobulins
Immunological Dichotomy
CHAPTER 5:
Classification of Leprosy
INDIAN LEPROLOGISTS' ASSOCIATION CLASSIFICATION (1955)
FIELD WORKERS' CLASSIFICATION
RIDLEY AND JOPLING'S CLASSIFICATION (1966)
TUBERCULOID TUBERCULOID (TT)
BORDERLINE TUBERCULOID (BT)
BORDERLINE BORDERLINE (BB)
BORDERLINE LEPROMATOUS (BL)
LEPROMATOUS LEPROMATOUS (LL)
CHAPTER 6:
Tuberculoid Leprosy
CLINICAL FEATURES
VARIANTS
DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
TREATMENT
CHAPTER 7:
Maculo-anesthetic Leprosy
CLINICAL FEATURES
Variants
Diagnosis
Differential Diagnosis
TREATMENT
CHAPTER 8:
Lepromatous Leprosy
CLINICAL FEATURES
Variants
Diagnosis
Differential Diagnosis
Neurofibromatosis
TREATMENT
CHAPTER 9:
Histoid Leprosy
CLINICAL FEATURES
Slit-skin Smears
Histopathology
Cytopathology
TREATMENT
CHAPTER 10:
Borderline (Dimorphous) Leprosy
CLINICAL FEATURES
Diagnosis
Differential Diagnosis
TREATMENT
CHAPTER 11:
Indeterminate Leprosy
CLINICAL FEATURES
Variants
Diagnosis
Differential Diagnosis
TREATMENT
CHAPTER 12:
Polyneuritic Leprosy
CLINICAL FEATURES
Diagnosis
Differential Diagnosis
TREATMENT
CHAPTER 13:
Leprosy in Children
CLINICAL FEATURES
Diagnosis
TREATMENT
CHAPTER 14:
Reactions in Leprosy
MECHANISM
Histopathology
TREATMENT
Type I (lepra) Reaction
Type II (ENL) Reaction
CHAPTER 15:
Ocular Leprosy
CLINICAL FEATURES
Indirect Secondary Involvement
Direct Eye Involvement
Diagnosis
TREATMENT
CHAPTER 16:
Deformities and Disabilities in Leprosy
GRADING OF DEFORMITIES/ DISABILITIES
Nerve Supply of the Hands
NERVE SUPPLY OF THE FEET
GRADING OF HAND DEFORMITIES
GRADING OF FOOT DEFORMITIES
GRADING OF FACIAL DEFORMITIES
Other Deformities
Epidemiology
PATHOGENESIS
PRIMARY DEFORMITY
SECONDARY CHANGES FOLLOWING NERVE PARALYSIS
Anesthetic Deformity
Motor Paralysis and Misuse of Function
Pathogenesis of Larynx Involvement
Pathogenesis Of Gynecomastia
Pathogenesis of Blindness in Leprosy
Prevention and Correction
DEFORMITY CORRECTIVE MEASURES
Physiotherapy
CHAPTER 17:
Therapy of Leprosy
DAPSONE
Acedapsone
Amithiozone
CLOFAZIMINE
RIFAMPICIN
ETHIONAMIDE
CHEMOTHERAPY OF LEPROSY
CHAPTER 18:
Newer Antileprosy Drugs
FLUOROQUINOLONES
MINOCYCLINE
MACROLIDES
PHENAZINE
RIFAMYCIN DERIVATIVES
CHAPTER 19:
Basic Requirements for Implementation of Multidrug Therapy
INTRODUCTION
THE MDT REGIMEN
THE BASIC REQUIREMENT WHICH MUST BE MET BEFORE IMPLEMENTING MDT
Political and Professional Commitment
A Plan of Action
Operational Guidelines
Competent Staff
Availability of Drugs
Collection of Basic Data
Case Detection Activities
Diagnosis
Laboratory Services
Care Activities
Surveillance after MDT Treatment
Rehabilitation Services
THE FRAMEWORK FOR IMPLEMENTATION OF MDT
CHAPTER 20:
Drug-resistance, Persisters and Relapse
CHAPTER 21:
Urban Leprosy
EPIDEMIOLOGY
PREVENTIVE MEASURES
CHAPTER 22:
Prevention and Control of Leprosy
TREATMENT
Social Welfare and Rehabilitation
Health Education
Implementation of Program
Segregation
Chemoprophylaxis
BCG Prophylaxis
CHAPTER 23:
Chemotherapy
Official regimens
NEW MDT REGIMENS
NEEDS FOR BOTH FLEXIBILITY AND RELIABILITY OF MDT TREATMENT
ABSENTEEISM AND DEFAULT
DRUG RESISTANCE
RECOMMENDATION
CHAPTER 24:
Epidemiology and Control
IMPACT OF MDT ON TRANSMISSION
Immunoprophylaxis
Chemoprophylaxis
Other Factors
Prevalence
Incidence
New Case Detection Rate
Proportion of Newly Detected Patients with Grade 2 Impairment
Proportion of Children
Proportion of MB Patients
Treatment Completion Rate
Relapses
CHAPTER 25:
National Leprosy Eradication Program—Indian Scenario
EPIDEMIOLOGICAL PROFILE AND LEPROSY TRENDS IN REGISTERED CASES IN INDIA
MODIFIED LEPROSY ELIMINATION CAMPAIGN (MLEC) VALIDATION
INFRASTRUCTURE FOR NLEP
RECOMMENDATIONS FOR NLEP IN THE COUNTRY
CHAPTER 26:
Leprosy—The Global Scenario
COUNTRIES ENDEMIC FOR LEPROSY
LEPROSY TRENDS IN INDIA FROM 1985
CHAPTER 27:
Leprosy Elimination Campaigns
LESSONS LEARNT
LECS IN FUTURE
Appendices
Appendix I: Bacteriological Status of Newly Detected Cases
Appendix II: Classification of Newly Detected Leprosy Cases
Appendix III: Contact Tracing
Appendix IV: Classification of Disabilities
Appendix V: Form for Recording Disabilities from leprosy
Appendix VI: Leprosy Vaccines
Appendix VII: Animal Models for Mycobacterium leprae
Appendix VIII: Early Diagnosis: Newer Techniques
Appendix IX: Standard Protocol
Appendix X: Vocabulary of Generic and Trade Names of the Drugs and Their Availability
INDEX
TOC
Index
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