View source for Disabled Village Children:Diagnosing Leprosy

{{bctrail|segments=3|chaptitle=Chapter 26: Leprosy: Hansen’s Disease}}
{{DISPLAYTITLE:Diagnosing Leprosy}}
{{SideSupplement|bookabbreviation=dvc|pagealt=is from page 217 of|chapterpdf=http://hesperian.org/wp-content/uploads/pdf/en_dvc_2023/en_dvc_2023_26.pdf|bookurl=Disabled Village Children|booktitle=Disabled Village Children}}
{{chaptertoc|In this chapter:|
 <ul class{{=}}"noprint">
<li>[[Disabled Village Children:Chapter 26: Leprosy: Hansen’s Disease|Chapter 26: Leprosy: Hansen’s Disease]]</li>
    <li>[[Disabled Village Children:Checking Children for Signs of Leprosy|Checking Children for Signs of Leprosy]]</li>
    <li>[[Disabled Village Children:Diagnosing Leprosy|Diagnosing Leprosy]]</li>
    <li>[[Disabled Village Children:Types of Leprosy|Types of Leprosy]]</li>
    <li>[[Disabled Village Children:Leprosy Reactions|Leprosy Reactions]]</li>
    <li>[[Disabled Village Children:Treatment and Management of Leprosy|Treatment and Management of Leprosy]]</li>
<li>[[Disabled Village Children:Prevention of Injury for Persons with Loss of Feeling and Strength|Prevention of Injury for Persons with Loss of Feeling and Strength]]</li>
<li>[[Disabled Village Children:Prevention of Contractures and Deformities in Persons with Paralysis|Prevention of Contractures and Deformities in Persons with Paralysis]]</li>
    <li>[[Disabled Village Children:Leprosy and the Community|Leprosy and the Community]]</li>
 </ul>
}}
Although skin patches are often the first sign of leprosy, many other diseases can cause similar patches. Only when there is a loss of feeling inside the skin patch, as compared with the skin outside the patch, can we be almost sure the person has leprosy. However, in some forms of leprosy, loss of feeling in skin patches may develop only years later, or not at all. Therefore, other evidence of leprosy must be looked for.

Another sign of leprosy—tingling, numbness, or loss of feeling in hands and feet— may also have other causes.

'''To make a fairly certain diagnosis of leprosy, the person should have at least 1 of these 3 major signs''':

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<td  colspan=2 valign{{=}}top style{{=}} "text-indent: -15px; padding-left: 25px;">'''1. definite loss or change of feeling&nbsp;in skin patches'''<br><br>'''''Note:''''' Leprosy patches on face often do not lose feeling as much as on other parts of the body.
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<td valign{{=}}top style="width:25%;">
<div class{{=}}speechbub style{{=}}"position: relative; ">
[[Image:DVC_Ch26_Page_217-1.png|325px|center|alt=A girl having a skin patch on her back being tested with feather]]
<div style{{=}}"position:absolute; width: 50px; left: 10px; top:36px;line-height:100%;">Do you feel this?</div>
<div style{{=}}"position:absolute; width: 110px; left: 205px; top:31px;line-height:100%;">Yes - but not the same as when you touched me in other places.</div></div></td>
</tr>
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<td valign{{=}}top style{{=}} "text-indent: -15px; padding-left:25px;">
'''2. definite enlargement of nerves'''<br>(See [[Disabled_Village_Children:Checking_Children_for_Signs_of_Leprosy#nerves|nerves to check]])</td>
<td>[[Image:DVC_Ch26_Page_217-2.png|175px|alt=An outstretched arm showing an enlarged nerve]]</td>
<td></td></tr>
</table>
<div class{{=}}page-break></div>
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<td rowspan=3 valign{{=}}top style{{=}} "text-indent: -15px; padding-left:25px;width:55%;">'''3. presence of leprosy bacilli in a skin smear'''<br>A split skin smear is prepared by cutting a thin layer of skin from a skin patch. Less commonly it is taken from the moist skin deep inside the nose—an area that is often heavily infected. The skin sample is placed on a glass slide, colored with special stains, and examined with a microscope.
'''</td>
<td style="width:15%;padding-left:15px;">[[Image:DVC_Ch26_Page_217-3.png|105px|center|alt=a scapula taking sample of skin patch from hand and a petri dish with that sample]]</td>
<td rowspan=2 style="padding-left:0px;width:15%;">[[Image:DVC_Ch26_Page_217-5.png|90px|right|alt=sample of skin patch under the microscope with bacilli present ]]</td>
<td  rowspan=2 style="line-height:110%;padding-right:0px;width:15%;">leprosy bacilli as seen in the microscope.</td></tr>

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<td style="line-height:110%;width:27%;padding-left:35px; padding-right:10px;">taking a “split skin smear” from a skin patch</td>
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<td colspan=3  style="padding-left:0px;padding-top:40px;">[[Image:DVC_Ch26_Page_217-4.png|175px|left|alt=A microscope]]</td></tr>
</table>
The bacteria (bacilli) of leprosy, if present, can be seen under the microscope.

{{openbox|
Whenever you suspect leprosy but the diagnosis is uncertain, a skin smear should be taken (by a trained worker).}}

{{note|Not many persons with leprosy show all 3 of these signs. Persons with loss of feeling in skin patches usually have no bacilli in their skin smears.}}



{{Previous and next sections|Checking Children for Signs of Leprosy|Types of Leprosy}}
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[[es:Disabled_Village_Children:Diagnóstico_de_la_lepra]]
[[en:Disabled_Village_Children:Diagnosing_Leprosy]]