Body's Response to Leprosy: Tuberculoid vs. Lepromatous Forms

Leprosy (Hansen's disease) manifests in a spectrum based on immune response to Mycobacterium leprae:

Tuberculoid (Paucibacillary) Leprosy

• Strong cell-mediated immunity.
• Few, well-demarcated, hypopigmented, anesthetic skin lesions.
• Granulomas contain bacteria; nerve damage localized.
• Milder, less contagious.

Lepromatous (Multibacillary) Leprosy

• Weak cell-mediated immunity; high bacterial load.
• Numerous, diffuse, poorly defined lesions (nodules, plaques).
• Widespread nerve, skin, mucosal, and organ involvement.
• Severe sensory loss, disfigurement, potential blindness.
• More contagious.

Borderline Forms

Intermediate immune responses exist (borderline tuberculoid, mid-borderline, borderline lepromatous) with mixed features.

Key Point

Early multidrug therapy (dapsone, rifampicin, clofazimine) halts progression, prevents disability, and renders patients non-infectious. WHO provides free treatment globally.