03 - How To Approach A Leprosy Presumptive Case?

The article "03 - How To Approach A Leprosy Presumptive Case?" deals with key points in history taking for any presumptive leprosy case to ascertain or rule out leprosy disease. 

This is not an exhaustive checklist but instead an indicative one. Readers are advised to do further research. The follow-up article will summarize the critical examination points to ascertain leprosy diagnosis.

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How to Approach a Leprosy Patient?

 

History

A.  General History

• Name / Guardian name (in case of a child):

• Age

• Gender

• Occupation

• Education

• Income

• Religion

• Category (General/SC/ST/OBC)

• Address and phone number

• National Identity Number (Any ID)

• State/Country of domicile

• National Health Scheme number (e.g. ABHA in India)

 

B. Presenting symptoms/complaints can vary:

• Skin patch

• Loss of sensation

• Tingling sensation,

• Burning sensation,

• Blisters on hand or feet

• Joint pain,

• Weakness of the hand or foot,

• Painless plantar ulcer, hand ulcer,

• Swelling in hand/foot or patches,

• Fever,

• Skin lesions, the eruption of nodules,

• Loss or thinning of hairs,

• Dryness or no sweating in some areas,

• Unable to close their eye,

• Watering eye,

• Red eye,

• Slipping of slippers while walking,

• Nasal block,

• Blood from the nose,

• Pain in testes

B.1 Duration  of  symptoms and mode of onset
B.2 Any pain in the nerve area
B.3 Itching on skin lesions
B.4 Frequent appearance or disappearance of patches or nodules

 
 

C. Previous treatment history & its response, and its record, if any

• Urine discolouration

• Skin discolouration

• Jaundice

• Any allergy, especially drug

• Steroid intake

• Diabetes

• Worm infestation

• Hypertension

• Leprosy treatment and duration

• Kala-azar

• Tuberculosis

 

D. Family history

• Similar skin lesions or abnormality of hand, foot, eye

• Diabetes, Hypertension, Tuberculosis, or HIV

 

E. Personal history

• Alcohol, tobacco or any drug abuse.

• Associated diseases like Diabetes, Tuberculosis, HIV, hypertension, Covid-19 

• Married/unmarried/children

• Pregnancy and lactation

• Drug reaction

• Any allergy

• Covid 19

 
F. Place where treatment taken
 
G. Distance from the treatment facility
 
H. Record history as per Internalized and Social Stigma scale
 
I.   Assess mental well-being before initiating the treatment