CLASSIFICATION OF LEPROSY (Ridley-

Jopling)
Indetermin Tuberculoi Borderline Borderline Borderline Lepromato
ate type d Type (TT) Tuberculoi Borderline Lepromato us Leprosy
d (BT) (BB) us (BL) (LL)
Number Solitary 5 or less More than Lesions are Numerous Innumerabl
and size of lesions, 5 lesions, numerous and large e, small
lesion less than more than but still
10 cm, 10 cm, countable
assymetric assymetric
Surface hypopigme Erythemat Less Dull or shiny shiny
changes nted ous or erythemat slightly
hypopigme ous and shiny
nted, less scaly
elevated
and
indurated
-dry, scale
and
hairless
 Indetermin Tuberculoi Borderline Borderline Borderline Lepromato
ate type d Type Tuberculoi Borderline Lepromato us Leprosy
(TT) d (BT) (BB) us (BL) (LL)
Primary Macule or Plaque, Plaque and large Macules, Pale
lesions patch on annular papule, annular papules, lepromato
the sites of with sharp annular, plaques nodules us macules
predilectio borders disticnt with -Solitary and
n: face, borders, islands of nodules are infiltration
arms, with normal skin numerous s with
thighs,butt satellite within the and symmetric
ocks lesions in lesions widespread al
and -well -large distributio
outside the delineated lesions have n
lesion borders ill defined -hard
with outer infiltration
satellite border and result to
papules sharply nodules
marginated (leproma)
inner
borders
(inverted
saucer)
 Indetermi Tuberculoi Borderline Borderline Borderline Lepromato
nate type d Type (TT) Tuberculoi Borderline Lepromato us Leprosy
d (BT) (BB) us (BL) (LL)
Nerve Sensory -occurs -Loss of Variable -appears -very
involvem function is early sensation anesthesia late slowly
ent normal or -lesions are in lesion is or -with or -acral,
minimally anesthetic assymetric hyposthesi without distal,
altered and -no more a hyposthesia symmetric
(hyposthe anhidrotic than 2- Sweating is anesthesia
sia) -superficial nerve normal
peripheral trunk -highest
nerve may involvemen prevalence
or may not t of nerve
be trunk
enlarged palsies
-acral,
distal,
symmetric
anesthesia
 Indeter Tuberculoi Borderline Borderlin Borderlin Lepromatou
minate d Type Tuberculoi e e s Leprosy
type (TT) d (BT) Borderlin Lepromat (LL)
e (BB) ous (BL)
Other Diffuse
findings dermal
infiltrations
resulting in
characteristi
c facies with
widened
nasal roof
and fusiform
swelling of
fingers
-madarosis
Bacterial 0 0 1+ 2+ 3+ 4+ or more
index
 WHO CLASSIFICATION
PAUCIBACILLARY (PB) MULTIBACCILARY
(MB)
Number of skin 2-5 6 or more
lesions
AND OR
Skin Smears Negative at all times Positive at any site
Ridley-Jopling TT, at most BT Some BT, BB, BL, LL
Correlation
 LEPROSY REACTION
Type 1 reaction (reversal reaction)
Type 2 reaction (Erythema Nodosum
Leprosum)
 Comparison of reversal reaction and
erythema nodosum leprosum
Reversal Reaction erythema nodosum
leprosum
Type of leprosy BT - LL LL and small number of BL
Relation to treatment Treated and untreated More common among
treated patients than
untreated, including
defaulters
manifestation -leprosy lesions become -crops of painful papules
swollen and erythematous and nodules developing in
-new lesions may erupt few hours and lasting
several months within 2 weeks or more
-successive crops may
occur over time
 Reversal Reaction erythema nodosum
leprosum

etiology - Change in delayed type Immune complex disease

of hypersensitivity to
M.leprae
- Increase in cell-mediated
immunity
complications Ulceration of the skin, Ulceration, neuritis, iritis,
neuritis orchitis, lymphadenopathy,
arthritis, proteinuria
management - NSAID (aspirin,
paracetamol) - Steroid (prednisone)
- Steroid (prednisone) - Clofazimine
- Clofazimine