DERMATOLOGY Leprosy, leishmaniasis, tuberculosis

NAME: MUHAMMAD NOORAIMAN AHMAD NOORDIN GROUP : 30 A

Leprosy
Leprosy, also known as Hansen's disease (named after physician Gerhard Armauer Hansen) It is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis. Primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions are the primary external sign.

Symptoms
Symptoms include: Skin lesions that are lighter than your normal skin color
Lesions have decreased sensation to touch, heat, or pain Lesions do not heal after several weeks to months

Muscle weakness Numbness or lack of feeling in the hands, arms, feet, and legs

Exams and Tests

Lepromin skin test can be used to tell the two different forms of leprosy apart, but it is not used to diagnose the disease Skin lesion biopsy Skin scraping examination

Possible Complications
Disfigurement Muscle weakness Permanent nerve damage in the arms and legs Sensory loss People with long-term leprosy may lose the use of their hands or feet due to repeated injury because they lack feeling in those areas.

Treatment
A number of different antibiotics (including dapsone, rifampin, clofazamine, fluoroquinolones, macrolides, and minocycline) are used to kill the bacteria that cause the disease. More than one antibiotic is often given together. Aspirin, prednisone, or thalidomide is used to control inflammation

Leishmaniasis
It is a parasitic disease spread by the bite of infected sand flies. There are several different forms of leishmaniasis. The most common are cutaneous and visceral. The cutaneous type causes skin sores. The visceral type affects internal organs such as the spleen, liver and bone marrow. People with this form usually have fever, weight loss and an enlarged spleen and liver. It is a disease caused by protozoan parasites that belong to the genus Leishmania and is transmitted by the bite of certain species of sand fly (subfamily Phlebotominae)

Symptoms
The symptoms are skin sores which erupt weeks to months after the person affected is bitten by sand flies. Other consequences, which can manifest anywhere from a few months to years after infection, include fever, damage to the spleen and liver, and anemia. In clinical medicine, leishmaniasis is considered one of the classic causes of a markedly enlarged (and therefore palpable) spleen; the organ, which is not normally felt during examination of the abdomen, may become larger even than the liver in severe cases. Leishmaniasis may be divided into the following types: Visceral leishmaniasis is the most serious form, and is potentially fatal if untreated. Cutaneous leishmaniasis is the most common form, which causes a sore at the bite site, which heals in a few months to a year, leaving an unpleasant-looking scar. This form can progress to any of the other three forms. Diffuse cutaneous leishmaniasis produces widespread skin lesions which resemble leprosy, and is particularly difficult to treat. Mucocutaneous leishmaniasis commences with skin ulcers which spread, causing tissue damage, to, particularly, the nose and mouth.

Treatment
Medicines called antimony-containing compounds are the main drugs used to treat leishmaniasis. These include: Meglumine antimoniate Sodium stibogluconate Other drugs that may be used include: Amphotericin B Ketoconazole Miltefosine Paromomycin Pentamidine Plastic surgery may be needed to correct the disfigurement caused by sores on the face (cutaneous leishmaniasis). Patients with drugresistant viral leishmaniasis may need to have their spleen removed (splenectomy).

Tuberculosis
Tuberculosis (TB) is a potentially serious infectious disease that primarily affects your lungs. The bacteria that cause tuberculosis are spread from person to person through tiny droplets released into the air via coughs and sneezes. Many strains of tuberculosis can resist the effects of the drugs most commonly used to treat the disease. People who have active tuberculosis must take several different types of medications together for many months to eradicate the infection and prevent development of antibiotic resistance

Cause
Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings. Although tuberculosis is contagious, it's not especially easy to catch. You're much more likely to get tuberculosis from someone you live with or work with than from a stranger. Most people with active TB who've had appropriate drug treatment for at least two weeks are no longer contagious

Symptoms
Although your body may harbor the bacteria that cause tuberculosis, your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between: Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later. Most people infected with TB germs never develop active TB. Signs and symptoms of active TB include: Cough Unexplained weight loss Fatigue Fever Night sweats Chills Loss of appetite

Organs are affected

Tuberculosis usually attacks your lungs. Signs and symptoms of TB of the lungs include: Coughing that lasts three or more weeks Coughing up blood Chest pain, or pain with breathing or coughing But tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs outside your lungs, symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.

Vaccine
Bacille Calmette Gurin, also known as BCG, is a vaccine given throughout many parts of the world. It is derived from an atypical Mycobacterium but offers some protection from developing active tuberculosis, especially in infants and children. This vaccination is believed to be important in parts of the world where TB is quite common. This is not the case in the United States, and the vaccine is not routinely administered in the U.S. When BCG has been administered, future PPD and Tine skin tests remain positive and can cause some confusion when trying to diagnose TB. It is also important to realize that even with a BCG vaccine in childhood, tuberculosis can still occur in an adult exposed to the tuberculosis bacteria, which calls into question the real utility and effectiveness of this vaccination.

Treatment
A person with a positive skin test along with an abnormal chest X-ray and sputum evidencing TB bacteria has active TB and is contagious. As already mentioned, active TB usually is accompanied by symptoms, such as a cough, fever, weight loss, and fatigue. Active TB is treated with a combination of medications along with isoniazid.Rifampin (Rifadin), ethambutol (Myambutol), and pyrazinamide are the drugs commonly used to treat active TB in conjunction with isoniazid (INH). Four drugs are often taken for the first two months of therapy to help kill any potentially resistant strains of bacteria.

 A person with a positive skin test, a normal chest X-ray, and no symptoms most likely has only a few TB germs in an inactive state and is not contagious. Nevertheless, treatment with an antibiotic may be recommended for this person to prevent the TB from turning into an active infection. The antibiotic used for this purpose is called isoniazid (INH). If taken for six to 12 months, it will prevent the TB from becoming active in the future. In fact, if a person with a positive skin test does not take INH, there is a 5%10% lifelong risk that the TB will become active.

Skin TB