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Why do deformities occur in Leprosy Patients?

Written by Dr Sunder Rao Bethapudy
Category: FAQs

Majority of the people in the western world still believe that Leprosy actually eats away the flesh and the bones, thus causing the deformities like loss of fingers and toes.


But this not true.

Mycobacterium Leprae that causes leprosy disease mainly effects skin and the nerves. Initially when the skin is involved there is a loss of hair, whether it is eyebrows, scalp, or over the arms and legs along with hypo pigmented ( white ) patches. There is definite loss of sensation over the patches due to damage to the nerves supplying that particular patch of skin with pale colour.

As the disease progress most of the peripheral (the nerves that lie just underneath the skin) nerves are involved with loss of sensation over the skin and deeper parts of the body. This results in loss of pain to the effected parts of the body, for example the feet, hands and so on.

Now then, although we spend millions of Pounds in money (£s) for the ‘’pain killers ‘’ tablets, pain in fact is a gift from God. Pain actually protects us from surrounding dangers like fire, needles, cuts and blunt instrument injuries. As it is a common saying for us to say ‘’my feet are killing me’’ after a long walk. And so we give rest to our feet.

However when there is no pain they can walk miles after miles ,sometimes without any footwear, until an ulcer appears on the sole of the foot. If that is not taken care of, the ulcer gets deeper and wider until the bones are seen. Injuries to the toes can occur
and the Leprosy patients do heal well. With repeated injuries gradually there is loss of toes and fingers can happen.  Loss of fingers occur due to deep seated burns with healing process  taking place at the same time.

Surgical amputation of legs due to massive ulcers that can not be treated with plastic surgery, are done for the leprosy patients
With just tourniquet to reduce the bleeding and no general anaesthesia is given as the pain is not felt. Of course there will be a screen so the patient may not see the surgical procedure.

Quite commonly you do get a ‘’claw hand ‘’ deformity, this is due to disparity  between the extensors( the muscles that extend the fingers) and the flexors (the  muscle that flexes)  of muscle power, again due to damage to the nerves that supply to the specific muscles.

Although leprosy is seen across all the sections of the society, rich and poor, predominantly the disease is seen among the poor. Because of the stigma and fear of contracting the disease, the employers do not employ. So the disease becomes secretive as the patient hides the disease as much as possible because his earning capacity to maintain the family will be gone. Once it is revealed he or she either loses or do not get a job.

Dr. Sunder Rao Bethapudy

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