Coeytaux Alessandra, Truffert André, Mueller Yolanda, Antille Christophe, Jackson Yves
Service de Neurologie, Policlinique de Neurologie, Département de médecine communitaire et de premier recours, HUG, 1211 Genève 14.
Rev Med Suisse. 2007 May 9;3(110):1178, 1180-4.
Leprosy is a treatable chronic infectious disease, caused by Mycobacterium leprae, not highly transmittable that affects mainly the skin and peripheral nerves. Often neglected because it is rare in western countries, it may be encountered in patients coming back from endemic areas. Diagnostic criteria include underpigmented patches with loss of sensation, thickened peripheral nerves and acid-fast bacilli on skin smears or biopsy material. The variation of the cellular immune response determines the different forms of the disease (tuberculoid to lepromatous) and the neurological impairment. A precise diagnosis is mandatory to adjust the treatment. Among the neurological complications the leprosy reactions are the most important because they may result in increased nerve damage and compromised recovery if the specific treatment is delayed.
麻风病是一种可治疗的慢性传染病，由麻风分枝杆菌引起，传染性不强，主要影响皮肤和周围神经。由于在西方国家较为罕见，该病常被忽视，但在来自流行地区的患者中可能会遇到。诊断标准包括色素减退斑伴感觉丧失、周围神经增粗以及皮肤涂片或活检材料中发现抗酸杆菌。细胞免疫反应的变化决定了疾病的不同形式（结核样型至瘤型）以及神经损伤情况。必须进行精确诊断以调整治疗方案。在神经并发症中，麻风反应最为重要，因为如果延误特异性治疗，它们可能导致神经损伤加重并影响恢复。
