Test: Hansen’s Disease - 2 - NEET PG MCQ

MDT must be maintained throughout the reaction. Steroids are the drug of choice.

Incision and drainage are necessary procedures. In the case of a nerve abscess, the use of steroids alone may not be adequate.
Incision and drainage alleviate pressure on the nerve and help to restore its function.

Rifampicin is a strong bactericidal agent. Four days following a single dose of 600 mg, the bacilli in the patient are no longer alive.

Clinical, bacteriological, immunological, and histological. This does not encompass pure neural types of Hansen's.

Ulnar is the most frequently affected peripheral nerve in leprosy. Most references, as cited below, provide evidence supporting ulnar as the predominant nerve.

• Harrison 19th edn (pages 1024, 1125)
• Harrison 18th edn
• The Classical Dharmendra Textbook of Leprosy Vol. 1 (pages 101, 209)
• IAL Textbook, 2nd edn (page 252)
• Yawalkar book (pages 30, 33, 88)

All of these sources affirm the ulnar nerve's prominence. However, two cohort studies conducted in 1999 and 2000 indicate that the posterior tibial nerve is the most commonly involved. Thus, consider the hierarchy as ulnar > posterior tibial.

The gastrointestinal tract, brain, lungs, heart, prostate, and female reproductive system are generally considered to be unaffected by leprosy; however, there have been case reports indicating involvement.

When choosing between the ovary and the uterus, the uterus is the preferred option for this question.

Lucio leprosy is a non-nodular, smooth form of lepromatous leprosy (LL). In the Lucio phenomenon, patients develop ulcers and necrotic hemorrhagic infarcts with serrated margins.

Lepromin is utilised for prognosis rather than diagnosis, as it serves as a marker for immunity.

• In early infancy, the immune system is underdeveloped, resulting in lepromin negativity.
• The BCG vaccine can also lead to a positive conversion.

The patient is experiencing a type 1 lepra reaction accompanied by nerve inflammation. Treatment options include:

• Steroids
• Splinting of the limb
• Analgesics

It is essential that anti-leprosy medications are not discontinued.

Steroids are the drug of choice for type 1 lepra reaction. The image depicts neuritis accompanied by ulceration. Dapsone should be maintained as part of the multidrug therapy (MDT) throughout the treatment for the reaction. Incision and drainage are performed for a nerve abscess resulting from severe neuritis.

ENL leads to:

• fever
• red, tender skin nodules
• hepatitis
• arthralgia (not arthritis)

Thalidomide has the potential to induce peripheral neuropathy, which can result in numbness in the hands and feet. The image depicts ENLs on the arms.

It is probable that the dark brown hyperpigmentation observed is a result of clofazimine administration. This hyperpigmentation is noticeable on the macrophages of certain patients, which adds to the overall pigmentation.

Thalidomide neuropathy affects approximately 20% of individuals within a year.

Immunoprophylaxis plays no part in leprosy. The BCG and BCG combined with killed M. leprae vaccines demonstrate inconsistent effectiveness in preventing leprosy. Additionally, both Mycobacterium vaccae and the ICRC vaccine have been explored.

An inverted saucer is characteristic of Bell's palsy. It is often accompanied by:

• Extensive glove and stocking distribution
• ENL (Erythema Nodosum Leprosum)
• Facial lesions

These symptoms are indicative of infectious leprosy.