Leprosy: clinical features and treatment

Published on June 29, 2022   53 min

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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.
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.
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.