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Diagnosis of leprosy - Part II . The 1 st cardinal signs of leprosy

Diagnosis of leprosy - Part II . The 1 st cardinal signs of leprosy. Salvatore Noto, Pieter A M Schreuder and Bernard Naafs Leprosy mailing list, October 2011. 1. The 1 st cardinal sign of leprosy. “Skin patch with loss of sensation”. 2. Testing for loss of sensation.

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Diagnosis of leprosy - Part II . The 1 st cardinal signs of leprosy

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  1. Diagnosis of leprosy - Part II.The 1stcardinal signs of leprosy Salvatore Noto, Pieter A M Schreuder and Bernard Naafs Leprosy mailing list, October 2011 LML October 2011 - The diagnosis of leprosy - Part II. 1st cardinal sign 1

  2. The 1st cardinal sign of leprosy “Skin patch with loss of sensation” LML October 2011 - The diagnosis of leprosy - Part II. 1st cardinal sign 2

  3. Testing for loss of sensation Courtesy of B. Naafs LML October 2011 - The diagnosis of leprosy - Part II. 1st cardinal sign

  4. Testing for loss of sensation • 1. Explain • 2. Demonstrate • Test when the patient • comprehends fully Courtesy of: S Noto LML October 2011 - The diagnosis of leprosy - Part II. 1st cardinal sign 4

  5. Hypopigmentation • Distribution • Margins • Streaming and satellite lesions Loss of sensation? Yes Leprosy Courtesy of: S Noto LML October 2011 - The diagnosis of leprosy - Part II. 1st cardinal sign

  6. Distribution • Margins • Streaming and satellite lesions • Surface is dry Loss of sensation? Yes. Leprosy LML October 2011 - The diagnosis of leprosy - Part II. 1st cardinal sign 6 Courtesy of: S Noto

  7. Addendum The sweat and histamine tests LML October 2011 - The diagnosis of leprosy - Part II. 1st cardinal sign 7

  8. Loss of sweating in hypopigmented leprosy macules Borderline leprosy The big leprosy lesion (arrow) is definitely dry while the normal skin is shiny from the reflection from the moisture of the sweat. Courtesy of Grace Warren LML October 2011 - The diagnosis of leprosy - Part II. 1st cardinal sign

  9. Loss of sweating in hypopigmented leprosy macula On the right side of the slide a round dry hypopigmented leprosy lesion. On the left normally pigmented skin with drops of sweat LML October 2011 - The diagnosis of leprosy - Part II. 1st cardinal sign Courtesy of Khon Kaen leprosarium

  10. The histamine test Normal response (redness)to injection of histamine = normal skin Diminished response (reduced redness) to injection of histamine = leprosy lesion Courtesy of J A da Costa Nery LML October 2011 - The diagnosis of leprosy - Part II. 1st cardinal sign 10

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