Hesperian Health Guides

Checking Children for Signs of Leprosy

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HealthWiki > Disabled Village Children > Chapter 26: Leprosy: Hansen’s Disease > Checking Children for Signs of Leprosy

In areas where leprosy is common, health and rehabilitation workers should work together with parents and schoolteachers to check all children regularly for early signs of leprosy. Most important are regular checkups of children in homes where persons are known to have leprosy. Checkups should be done every 6 to 12 months and should be continued for at least 3 years.


A slowly growing patch on the skin that does not itch or hurt. The patch may be somewhat different in color from the surrounding skin. (Patches of leprosy are never completely white, and are not scaly, except during a reaction.)

Note: In early skin patches, feeling is often normal, or nearly so. If feeling is clearly reduced inside a patch, leprosy is almost certain

What to look for

Examine the whole body for skin patches, especially the face, arms, back, butt, and legs.

An arm with a round pale patch on it
If you find a slightly pale patch without a clear edge, keep watching the spot. Unless feeling is reduced inside the patch, look for other signs before deciding it is leprosy. (Many children have similar pale spots on cheeks and arms that are not leprosy.
A man's chest with a two different types of round skin patches
ringworm-like patches, with or without raised border


1. Tingling, numbness, or some loss of feeling in the hands and feet. Or definite loss of feeling in skin patches.


With the tip of a feather or stiff thread, lightly touch the skin inside and outside the patch and have the child tell you (without looking) where he feels the touch.
Middle of a skin patch is being tested with a thread, and another patch is being tested with a needle
If the child cannot feel the thread, try pricking lightly with a sterile needle.

In a similar way, test for a numbness or reduced feeling in the hands and feet.
A boy closing his eyes while a cloth is being put oin his skin patch
I feel it here.

WARNING! Sterilize the needle in a flame before testing another child.

2. Slight weakness or deformity in the hands and feet.
A dropped foot with toes curled in
drop foot (Child cannot raise it.)
weakness or clawing of toes
Have the child straighten her fingers. If she cannot do this, it may be a sign of paralysis from leprosy. Also have the child try to touch the base of her little finger with her thumb.
DVC Ch26 Page 216-8.png
Muscle weakness here makes this movement difficult and may be a sign.
back of the hand with fingers slightly curled
Hand with palm up with unstraight fingers
CAUTION! These weaknesses may also be caused by polio, muscular dystrophy, or other problems.
3. Enlargement of certain nerves, with or without pain or tenderness. The affected nerve feels like a thick cord under the skin. When they are quite thick, they may be easily seen.
DVC Ch26 Page 216-9.jpg
Check for large nerves in these places.
A boy standing with arrows pointing to places that can be checked for large nerves
Also check for large nerves in or near skin patches.
thickening nerve below the ear (See Other Resources)

This page was updated:21 Nov 2019