TY - CHAP M1 - Book, Section TI - Leprosy A1 - Salgado, Claudio Guedes A1 - Cardoso de Brito, Arival A1 - Salgado, Ubirajara Imbiriba A1 - Spencer, John Stewart A2 - Kang, Sewon A2 - Amagai, Masayuki A2 - Bruckner, Anna L. A2 - Enk, Alexander H. A2 - Margolis, David J. A2 - McMichael, Amy J. A2 - Orringer, Jeffrey S. PY - 2019 T2 - Fitzpatrick's Dermatology, 9e AB - AT A GLANCEDefinition: A chronic granulomatous disease affecting mainly the skin and nerves caused by the obligate intracellular pathogen Mycobacterium leprae.Involvement: Primarily the skin and nerves, but causing sequelae to a wide range of tissues and systems including eyes, upper respiratory tract, lymphoid tissue, testicles, muscles, and bones.Diagnosis: Based on clinical signs and symptoms, hallmarks include loss of sensation within skin lesions, nerve swelling or pain, or demonstration of acid-fast bacilli in skin smears or biopsies.Incidence: 214,783 new cases detected worldwide in 2016, essentially unchanged for the last 4 years. More than 80% of all new cases are detected in only 3 countries—India, Brazil, and Indonesia.Long-term morbidity: Despite the global use of multidrug therapy in use since the mid-1980s, up to 30% to 50% of all leprosy patients will experience some type of reactional episode that may result in a permanent neurologic deficit or disability.A clinical challenge: The long incubation time prior to the slow development of diverse symptoms (3-7 years postinfection), the very low rate of disease progression in infected individuals, and issues with misdiagnosis all create challenges to the development of ways to interrupt transmission.An immunologic spectrum of disease: Understanding what genetic factors and the interplay of innate and adaptive immune responses of the host that leads to resistance or susceptibility to disease are critical in developing novel treatment approaches. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - dermatology.mhmedical.com/content.aspx?aid=1172926652 ER -