The diagnosis and treatment of leprosy is of great significance for leprosy epidemiology, treatment of patients and prevention of deformity. Therefore, only by diagnosing leprosy early and treating leprosy correctly can unnecessary suffering be avoided.
In 2013, Professor Zhou Yanchun of the Center for Disease Control and Prevention of Qitaihe City, Heilongjiang Province, mentioned in an article that the diagnosis of leprosy mainly includes: sensory impairment; peripheral nerve enlargement; detection of leprosy in the lesion; and histopathological basis. Leprosy can be diagnosed as long as the patient meets two of the four points.
The first two items seem easy to understand, and we mentioned them in previous articles. Intradermal examination of Leprosy mainly refers to laboratory tests: Bacillus leprosy test, leprosin test, serological testing of leprosy antibodies, and other tests.
Bacillus leprosy examination is simple, that is, taking materials on the active lesions of the skin and mucosa, scraping the tissue fluid at the lesion, smearing, and performing acid-resistant staining. Of course, the different types of leprosy symptoms, the results of the examination are also different. The amount of neoplastic leprosy is the largest, followed by the boundary type of hemorrhage, the amount of intermediate boundary and boundary class partial tuberculous-like bacteria is gradually decreasing, the tuberculosis type is negative, and the undetermined class is generally negative.
The leprosy test is a method of measuring the body's resistance to leprosy. It can reflect the strength of the body's immune response to leprosy cells. The test process is to inject crude leprosybin 0.1 ml in the forearm flexion side of the skin, there is infiltrative erythema at the injection site 48 hours later, according to the diameter of the erythema to judge the degree of positivity, 21 days after injection to observe the late reaction, whether there is an invasive nodule and rupture.
The "early response" reflects the body's sensitivity to Leprosy, while the "late response" indicates the body's ability to respond specifically to the cellular immune response of the leprosy. Late tuberculous leprosy reactions were strong positive, followed by the boundary class nodule type and undetermined class, while the other types of late reactions were negative.
The serological detection of leprosy antibodies mainly includes fluorescent antibody absorption test, enzyme-linked immunosorbent test, radioimmune test and so on. Can assist in infections with leprosy, especially subclinical infections.
In terms of treatment, the treatment of leprosy is similar to the treatment of other infectious diseases, and it is necessary to adopt the principles of early, timely, adequate, full-course and regular treatment. It should be noted that even if the patient's clinical manifestations are cured, it is necessary to continue to give consolidation therapy to avoid recurrence.
At present, the treatment of leprosy mainly includes combination therapy, immunotherapy, treatment of comorbidities, treatment of leprosy response and consolidation therapy.
Combination therapy, as the name suggests, is the use of two or more effective chemotherapy drugs with different mechanisms of action. It is generally necessary to include the strong bactericidal drug rifampicin.
Immunotherapy is to correct the immune deficiencies present in leprosy patients, to accelerate the elimination of dead bacteria, reduce the incidence of nerve damage and leprosy reactions, and reduce recurrence. For example, intravenous injection of peripheral hemolymocytes, intravenous injection of specific transfer factors, and intradermal injection of inactivated leprosy.
Treatment of comorbidities mainly includes treatment of deformities of the extremities and plantar ulcers. For example, surgical correction is given to people who have deformed, and dead bones are removed from ulcers.
In the treatment of leprosy reactions, it is generally not necessary to discontinue antileasperants except for severe reactions. Prompt treatment should be done to remove the trigger. The treatment drugs here mainly include corticosteroids, cyclosporine A, triptolide and so on.
Although leprosy has been developed for more than 2,000 years, there is still no slack in the attitude of eradicating the disease. In order to make leprosy more informed, the World Health Organization has also established "International Leprosy Day" (also known as "World Day against Leprosy"), which is held on the last Sunday of January every year. The establishment of this festival is not only a call for more people to pay attention to leprosy patients, but also an expectation for the early eradication of leprosy.
bibliography:
ZHOU Yanchun. Clinical treatment analysis of leprosy[J]. World Latest Medical Information Digest, 2013, 13(27):2.