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              Printable Handouts
Navigable Slide Index
- Introduction
 - Overview of lecture
 - Why leprosy?
 - Key facts
 - Leprosy spectrum
 - Leprosy clinical spectrum
 - WHO cardinal signs of leprosy (2012)
 - The disease spectrum
 - Indeterminate leprosy
 - Presentation of leprosy
 - Sites where enlarged nerves can be felt
 - Examining nerves in a patient
 - Neurological evaluation (1)
 - Nerve damage
 - Neurological evaluation (2)
 - WHO disability grading
 - Peripheral nerve damage (1)
 - Peripheral nerve damage (2)
 - Peripheral nerve damage (3)
 - The eye in leprosy (1)
 - The eye in leprosy (2)
 - Diagnostic tests
 - Serological tests
 - Serological tests and PCR
 - Nerve and skin biopsy
 - Bacteriological index
 - Diagnosis of leprosy
 - Treatment of leprosy
 - Leprosy MDT
 - Chemotherapy
 - Adverse effects
 - MDT success story
 - Checklist for new patients
 - MDT treatment - endpoints
 - U-MDT
 - Screening contacts and propylaxis
 - Immunological complications
 - Type 1 (reversal) reactions
 - Treatment of type 1 reactions
 - Neuritis
 - Type 2 (ENL) reactions
 - Clinical features of ENL
 - ENLIST ENL severity scale (EESS)
 - Treatment of ENL (1)
 - Treatment of ENL (2)
 - Household costs
 - Monitoring Adverse effects of steroids
 - Studies on treatment of type 1 reactions
 - Type1 reactions – second Line agents
 - Steroid treatment of reactions summary
 - Neuropathic pain (1)
 - Neuropathic pain (2)
 - Summary
 - Thanks
 - References
 
Topics Covered
- Leprosy disease Ridley-Jopling spectrum
 - Clinical signs of leprosy and leprosy presentation
 - Diagnostic tests for leprosy
 - Leprosy antibacterial treatment
 - Type 1 reactions
 - Erythema nodosum leprosum
 - steroid treatment
 - Neuropathic pain
 
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Lockwood, D.N. (2024, July 23). Leprosy: clinical features and treatment [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 4, 2025, from https://doi.org/10.69645/UCKO2872.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Diana N.J. Lockwood has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
 
Leprosy: clinical features and treatment
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Transcript
Please wait while the transcript is being prepared...
      
      
        
                  0:00
                
                
                  
                    Hello. It's a great pleasure
to be talking about leprosy.
                  
                    I'm Diana Lockwood,
                  
                    and I'm a Professor
of Tropical Medicine.
                  
                    I've spent a lifetime
working on leprosy.
                  
                    I want to share the interest
                  
                    and challenges of leprosy
with you in this talk.
                  
                
              
                  0:18
                
                
                  
                    In this talk, I'm going to talk
                  
                    about the clinical
signs of leprosy.
                  
                    That's very important
                  
                    because leprosy is
diagnosed clinically
                  
                    on the basis of the skin
lesions and the nerve lesions.
                  
                    I'm going to talk about the
presentation of leprosy,
                  
                    the different range
of skin lesions
                  
                    that people can present with
                  
                    and I'm going to talk about
the examination of the skin
                  
                    and the nerve that's important
to diagnose leprosy.
                  
                    We're fortunate
because leprosy is a
                  
                    very treatable mycobacterial
infection and we have
                  
                    antibiotics that work very
well and give a good outcome
                  
                    in terms of treatment with
a very high cure rate.
                  
                    However, leprosy
is complicated by
                  
                    these immunological
events called reactions,
                  
                    and these are when patients have
                  
                    episodes of increased
inflammation
                  
                    and they present as
new inflammation in
                  
                    the skin lesions and
inflammation in the nerve,
                  
                    which is called neuritis.
                  
                    Then finally, there's the
prevention of disability
                  
                    and this is very
important in leprosy
                  
                    because leprosy is a
disabling disease.
                  
                
              
                  1:26
                
                
                  
                    People often ask why did I
get interested in leprosy?
                  
                    The answer is because I had
                  
                    a gap year between
school and university,
                  
                    and I volunteered in a leprosy
hospital in India in 1975.
                  
                    When I was at the hospital,
                  
                    the man running
the hospital said
                  
                    leprosy is a really
interesting disease and
                  
                    I could see it was
because they were
                  
                    just getting new antibiotics
to treat leprosy.
                  
                    But I could also see
that you could prevent
                  
                    a lot of the nerve
damage by helping people
                  
                    look after their hands and feet,
                  
                    and so getting people
to do self-care.
                  
                    After that, I then
travelled home over land.
                  
                    The map shows my
journey across Pakistan
                  
                    and then around Afghanistan
                  
                    and then across Iran
and then up to Turkey.
                  
                    I did this as a
single 18-year-old
                  
                    and I had a fascinating time.
                  
                    Of course, Afghanistan
has completely changed
                  
                    since I was there in
1975, as has Iran.
                  
                    That gave me a lot of interest
in leprosy and interest in
                  
                    travel and I'm very
glad that I've been
                  
                    able to combine the two.
                  
                    I came back to Birmingham
                  
                    and then I trained
in medicine there.
                  
                    Obviously, I was interested
in infectious diseases
                  
                    and I then did student
projects on leprosy
                  
                    because I knew that I wanted
to do research on leprosy.
                  
                    I then moved to London and
                  
                    I trained in general
medicine and
                  
                    specialised in
infectious diseases
                  
                    and then super-specialised
in leprosy.
                  
                    I did research on leprosy and
that took me back to India.
                  
                    Then I was very lucky
because in 1994
                  
                    the one NHS leprologist retired
                  
                    and so I was able
to take his post
                  
                    and be the UK leprologist.
                  
                    I then combined a career
in medicine and research
                  
                    because I did my academic work
                  
                    at the School of Hygiene
and Tropical Medicine.
                  
                    What I've done is a lot
of work on trying to
                  
                    improve outcomes for
leprosy patients.