Leprosy lepromatosa A30.50

Severe, anergic, infectious, multibacillary form of leprosy with poor immunity of the organism. Special form: diffuse leprosy.

Skin symptoms: Symmetrically arranged, blurred, round or oval maculae, especially on covered areas of the body. Skin-coloured or brownish-red infiltrates. Sharply defined nodules (= leprosy), a few millimetres to centimetres in size, which develop from maculae or in normal skin, especially at pressure points. Dryness (ichthyosis of the legs), anhidrosis, alopecia, anaesthesia. Ulcerations and perforations are possible (lepromatous gummae), then there is an increased risk of secondary infection.

Facies leontina: Large-area infiltrates and leprosy in the face, leaving out the skin folds. Keratoconjunctivitis, enlargement of the earlobes, hair loss of the eyelashes and lateral eyebrows(madarosis).

Diffuse lepromatosis is characterized by a generalized waxy infiltration of the skin. Alopecia of eyelashes, eyebrows and scalp, see below Alopecia lepromatosa. Infestation of mucous membranes:

• Nasal mucosa with chronic rhinitis, destruction of the nasal septum with development of a characteristic saddle nose; laryngeal mucosa with purulent laryngitis and respiratory distress, and
• Eyes with severe damage due to infiltration, which can lead to lagophthalmus (symptom of insufficient active eyelid closure, resulting in widening of the eyelid crease), visual impairment and blindness
• and nerves with paralysis and loss of sensitivity.

Visceral involvement: Adenopathy, hepatosplenomegaly, orchitis, epididymitis (risk of sterility), osteitis, cachexia.

Note: In this form of leprosy, so-called leprosy reactions are observed.

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