Kuliah S2 Keperawatan Leprosy Diagnosis and Treatment

8/18/2019 Kuliah S2 Keperawatan Leprosy Diagnosis and Treatment

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LeprosyLeprosyDiagnosis and Treatment

DR. Dr. M. Yulianto Listiawan, SpKK(K),FINSDV, FAADV


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Diagnosis of leprosy is based on clinicalsigns and symptoms.

ONE of following cardinal sign:1. Hypopigmented or reddish skinlesions! with de"nite loss of sensation#

$. %n&ol&ement of the peripheral ner&es'as demonstrated by loss of sensation andweakness of the m(scles of hands' feetor face#

). skin smear positi&e for acid*fast bacilli.


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+kin lesion

* single or m(ltiple'

* (s(ally less pigmented than thes(rro(nding

normal skin

* sometimes the lesion is reddish or copper*

colo(red * a &ariety of skin lesions may be seen b(t

mac(les ,at!' pap(les raised!' or

nod(les are common


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+ensory loss is a typical feat(re of leprosy

The skin lesion may show loss ofsensation to pin pick and-or light to(ch

thickened ner&e is often accompanied

by other signs as a res(lt of damage tothe ner&e.

These may be loss of sensation in the

skin and weakness of m(scles s(ppliedby the a/ected ner&e


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Memiliki sifatMemiliki sifat4 – A :4 – A :

AnaesthesiAnaesthesi

AnhydrosisAnhydrosis

AchromiaAchromia

AtrophyAtrophy


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Light to(ch

Temperat(rediscrimination0ain pin prick!


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NE2E ENL3E4ENT


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5%: total n(mber of bacilli4%: 6 of solid staining bacilli' n(mber of &iablebacilli


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Classifcation o l!pros"Classifcation o l!pros"Leprosy can be classi"ed on the basis

of clinical manifestations and skinsmear res(lts.

+kin smears 1. 0a(cibacillary leprosy 05! :negati&e

smears at all sites$. 4(ltibacillary leprosy 45! : positi&e

smears at any site


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7linical criteria for classifying anddeciding the appropriate treatmentregimen for indi&id(al patientspartic(larly in &iew of the non*

a&ailability or non*dependability of theskin*smear ser&ices!

0a(cibacillary leprosy : $*8 skin lesions

4(ltibacillary leprosy : 9 "&e skin lesions


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p to 1;< bacteriaper gram tiss(e

0henolic3lycoLipid*1

Lepromin test


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#AM$ARAN KLINIKM.%.

&'$RC'LID $RDRLINL*RMA&'S

CLL'LAIRIMM'NI&Y

%'MRALIMM'NI&Y

+'MLA%$ASILK'S&A


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L*RSY CLASIFFICA&INL*RSY CLASIFFICA&IN

% (-/0 )1% (-/0 )1

*ausi2$asil!r (*$) M'L&I2$ASILR (M$)


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*olar &u3!rculoi4*olar &u3!rculoi4 &"p!&"p!

( && )( && )


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$or4!rlin! &u3!rculoi4( $& )


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Mi42

3or4!rlin!

( $$ 5 t"p!)


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$or4!rlin! L!pro6atous( $L )


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*olar L!pro6atous ( LL )*olar L!pro6atous ( LL )


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L*RSY7S CM*LICA&IN

• 1. 4adarosis

• $. +addle nose

• ). 3ynecomastia• =. Hand and foot dissability

• 8. E7T%ON O> LE0O+?


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Lagoptalm(s ofreaction

+DDLE NO+E


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% R!co66!n4!4 tr!at6!nt% R!co66!n4!4 tr!at6!nt

r!8i6!nsr!8i6!ns

Dapson! Ria6picin

d(lt

8; * @; kg

1;; mg

3i&en daily

A;; mg

3i&en once a month(nder s(per&ision

7hild1; * 1= yearsa

8; mg3i&en daily

=8; mg3i&en once a month(nder s(per&ision

a dC(st dose appropriately for child less than 1; years. >oreample' dapsone $8 mg daily and rifampicin );; mg gi&en once amonth (nder s(per&ision

9 Mont: r!8i6!n or *auci3acillar" (*$)L!pros"


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-; 6ont: r!8i6!n or-; 6ont: r!8i6!n or Multi3acillar"Multi3acillar"

(M$) L!pros"(M$) L!pros"Dapson! Ria6pici

nRia6picin

Cloaor

eample' dapsone $8 mg daily' rifampicin );; mg gi&en once amonth (nder s(per&ision' clofaimine' 8; mg gi&en twice a week'and clofaimine 1;; mg gi&en once a month (nder s(per&ision


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Kuliah S2 Keperawatan Leprosy Diagnosis and Treatment

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