Hansen's disease is an infectious skin disease that is chronic which affects the peripheral nerves, nasal mucosa, skin, eyes and upper respiratory tract. Hansen's disease, also known as Leprosy an infectious disease causes severe skin sores that can be disfiguring and may also cause nerve damage in the arms and legs. The disease is assumed to spread via nasal droplets or through broken skin or through secretions from the infected person's body that may contain the bacteria. Hansen's disease is not contagious and does not spread by merely coming in contact with the infected person.
Hansen's disease has been reported since ancient times and each culture across the world had a different understanding of the condition. Indians, Chinese and the Egyptians felt it was a contagious disease that was incurable. The outlook towards the disease has changed in the recent past. If the condition is diagnosed at an early stage and treated, it is curable. Though not completely eradicated, the disease has become rare and the number of cases of leprosy have reduced. Reported cases are from parts of Africa, Asia and very few cases in America.
Hansen's disease cause
A slow growing bacterium called Mycobacterium Leprae causes the condition. Leprosy is also called Hansen's disease named after the scientist who discovered the bacteria that caused the condition.
Hansen's disease symptoms
The skin and the peripheral nerves (nerves outside the brain and spinal cord) are largely affected by this condition. The nasal mucosa, eyes and upper respiratory tract also get affected. It takes about 3-5 years for symptoms to appear from when the person has come in contact with the bacteria.
Hansen's Disease Types
Depending on the number of skin sores and its type, leprosy can be classified into the following types:
Lepromatus: A severe form of the disease that has extensive skin bumps and rashes. Kidneys, nose and male reproductive organs get affected. Muscle weakness and numbness is also felt. This type is more contagious.
Tuberculoid: This is a mild form of leprosy; people with this type have flat and pale colored patches on the skin. The pale colored patches on the skin may feel numb due to the nerve damage beneath the skin. This type of leprosy is less contagious.
Borderline: People suffering from this type of leprosy have symptoms of both lepromatus and tuberculoid.
Mid-borderline: Asymmetrically distributed reddish plaques can be seen. Swollen lymph nodes may also be seen; they either regress or progress to other forms of leprosy.
Indeterminate: A few hypo-pigmented macules may be seen; they either heal or progress to become other forms of leprosy.
Hansen's disease diagnosis
Diagnosis is based on the clinical symptoms such as localized skin lesions and sensory loss. Skin biopsy is done. A skin smear test may also be done. Without taking proper treatment, this disease can cause severe complications like:
Hansen's disease treatment
It is a myth that leprosy cannot be treated. For the past two decades, over 16 million people with leprosy have been treated. WHO offers free treatment for people suffering from leprosy. Treatment of leprosy depends upon the type. Treatment includes:
Hansen's disease Facts
Certain skin conditions like Multiple Myeloma (a type of Cancer due to abnormal plasma cells), Hansen's disease (Leprosy) can be treated or the symptoms mitigated using thalidomide. It reduces redness and inflammation in Hansen's disease. It reduces the formation of blood vessels that feed tumors and thus is used extensively in cancer treatment. Thalidomide is an immunomodulatory agent. It works on the immune system to decrease certain substances that cause skin inflammation. Thalidomide is also prescribed for treatment of Sarcoidosis, HIV and Crohn's disease.
Thalidomide as a drug was primarily developed and used as a sedative to treat insomnia, anxiety and tension. The drug is also known as Asmaval, Valgis, Tensival, Distaval Forte and Valgraine. The drug that was popular as a wonder drug was banned in the early 1960s as it was found to cause deformity in children born to mothers who consumed this drug. Thalidomide caused severe to life threatening birth defects when either the father or mother consumed it during the time of fetal conception. Studies prove that this drug did cause birth defects in body parts like the eyes, face, heart, legs, bones and ears. Thalidomide blocked the formation of blood vessels thereby limiting blood flow and creating limbless babies.
In the 1970s thalidomide was used to treat leprosy. Later it was used as an anti-angiogenic - to stop the formation of new blood vessels. The same property of the drug which caused birth defects actually played a vital role in shrinking tumors. Thalidomide is used to treat cancer as it:
This medication should be taken orally. It is usually taken at bedtime, an hour after taking a meal. Handle the capsules with care; do not take them out of the blister pack if not being used immediately. Do not break the capsule. In case of skin contact with the powder, wash the area with soap and water. Hands should be washed thoroughly after handling the drug.
Pregnant women should not consume this drug. Doctors provide dosage based on the prevailing conditions, dosage should not be increased or decreased by the patient. Increase in dosage can cause serious side effects. Do not donate blood or sperm while on this drug. Avoid sexual contact while on this drug as the semen carries the drug in it. To get the maximum benefit of this drug, it has to be used regularly and should not be stopped suddenly. Stopping intake of the drug suddenly may worsen the condition.
While on this drug, make sure that your blood does not come in contact with any other person's blood. Thalidomide can make a person feel sleepy; hence alcohol should not be consumed while on this drug.
Thalidomide side effects
Side effects may vary from person to person. Common side effects include dizziness, chest pain, risk of blood clots, general weakness, racing heartbeat, dry skin, seizures and muscle cramps. Nerve damage may cause permanent damage in a few cases. Rare side effects include blood in urine, low blood pressure, reduced urination and fever without rash.
Leukoderma or vitiligo as it is sometimes called, is a chronic skin condition that causes loss of pigment leading to pale spots of skin. Leukoderma can be described as an autoimmune skin disease where the body destroys its own pigment cells, melanocytes. After the pigment disappears, small or even larger areas of skin become white with sharp margins where they join unaffected parts of skin. The hair in these areas also grow white rather than pigmented. Leukoderma is more noticeable during summer when the normal skin darkens. The causes for leukoderma could be a combination of genetic and environmental factors. Inheritance seems to be a dominant trait for this condition.
Leukoderma may also occur at sites of injury to the skin and may show itself as scars or burns. Recent studies suggest that leukoderma could be caused by the development of an antibody to an enzyme in the pigment cell. Leukoderma may be caused due to several other factors as well - congenital as in tuberous sclerosis, partial albinism and Piebaldism and Waardenburg's syndrome. The immunological causes of leukoderma are Vitiligo and Halo mole. Thermal burns, Dermatitis or eczema and Psoriasis may also result in leukoderma. Infectious conditions such as Pityriasis versicolor, leprosy, lichen planus and syphilis could also result in leukoderma. Some occupational hazards that could cause leukoderma are exposure to depigmentation agents such as tertiary butyl phenol and exposure to chemicals.
The spots can spread, shrink or remain the same. It is often noticed that patches occur in symmetrical fashion across both sides of the body. Some times mild trauma to an area of skin can cause new spots as around ankles caused by friction due to shoes or sneakers. Corticosteroid ointment or cream of appropriate strength is used depending on the site involved. Normally a mild steroid is used on the face and a stronger one for the trunk and limbs. A specialized form of light treatment PUVA is also of value to some patients.
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Bibliography / Reference
Collection of Pages - Last revised Date: June 20, 2019