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Leprosy is a chronic bacterial infection with Mycobacterium leprae. About 95% of people who are exposed to Mycobacterium leprae do not develop leprosy because their immune system fights off the infection. It attacks the nervous system, particularly the nerves of the hands, feet and face. It mainly affects the skin and peripheral nerves and also the respiratory mucosa and the eyes. Sufferers feel no pain in these areas and are thus likely to injure themselves without realising it. Leprosy has two frequent forms, tuberculoid and lepromatous, and these have been more subdivided. Both forms produce sores on the skin, but the lepromatous type is most severe, producing large, disfiguring nodules. All forms of the disease finally reason peripheral neurological damage which causes sensory loss in the skin and muscle weakness. Leprosy is common in many countries worldwide, and in temperate, tropical, and subtropical climates. More than 1 million people worldwide have leprosy. Leprosy is most common in Asia (especially India and Nepal), Africa, Latin America, and the islands of the Pacific Ocean. About 4,000 people in the United States are infected. Leprosy can affect all ages and both sexes. The infection can start at any age but most commonly begins in the 20s and 30s. Lepromatous leprosy symptoms are a chronically stuffy nose and many skin lesions and nodules on the front and back of the body. Sensation loss starts at the fingers and toes and may only affect a small patch of skin to begin with. The loss of sensation can lead to unnoticed injuries which may in turn become infected. In tuberculoid leprosy, a rash appears, consisting of one or a few flat, whitish areas. Areas affected by this rash are numb because the bacteria damage the underlying nerves. In lepromatous leprosy, many small bumps or larger raised rashes of variable size and shape appear on the skin. The Treatment of leprosy includes early pharmacotherapy and physical, social, and psychological rehabilitation. The goals of pharmacotherapy are to stop the infection, reduce morbidity, prevent complications, and eradicate the disease. Surgery may sometimes be used to drain abscesses to restore nerve function, reconstruct collapsed nose, or to improve function or appearance of affected areas. Oral corticosteroids and thalidomide are helpful in preventing nerve damage by reducing swelling.
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