Leprosy pp 75-110 | Cite as

Clinical Features

  • Enrico Nunzi
  • Cesare Massone
  • Salvatore Noto


The wide range of cutaneous clinical features of leprosy arises from the interaction between Mycobacterium leprae and the cell-mediated immunity of patients; clinical aspects can be seen in a spectrum (Ridley–Jopling) which ranges from the tuberculoid (TT) hyperergic pole to the lepromatous (LL) anergic pole. TT is characterized by single or a few lesions (macules, plaques, and papules) grouped together, asymmetric arrangement, well-defined edges, and anesthetic dry surface. LL is characterized by large number of lesions (macules, plaques, and nodules), smooth surface, preserved sensitivity, presence of acid-fast bacilli (AFB), and symmetric distribution pattern. Between these two extreme forms there is an interpolar or borderline group where it is possible to distinguish BT, BB, and BL. BT leprosy has anesthetic, asymmetric lesions (which include macules, plaques, and papules). In the middle part of the spectrum (BB form) there is high immunological instability with propensity for type 1 leprosy reaction. The BB form is clinically characterized by lesions with symmetric distribution, polymorphic aspect, and AFB presence in lesions. The BL form has symmetric arrangement of lesions (macules, plaques, and nodules), but they are fewer than in the anergic LL form and they contain AFB.


Lepromatous Leprosy Tuberculoid Leprosy Leprosy Reaction Annular Lesion Skin Smear 
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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  1. 1.Department of DermatologyUniversidad Tecnica Particular de LojaLojaEcuador
  2. 2.Department of DermatologyMedical University of GrazGrazAustria
  3. 3.Consultant for: Centre for Research in Leprosy and Tropical Dermatology (CIRLEP)University of GenoaGenoaItaly

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