Leprosy lepromatosa A30.50

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Lepromatous leprosy; Leprosy lepromatous; leprosy tuberosa; Multibacillary leprosy

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Severe, anergic, infectious, multibacillary form of leprosy with poor immunity of the organism. Special form: diffuse leprosy.

Clinical features
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Skin symptoms: Symmetrically arranged, blurred, round or oval maculae, especially on covered areas of the body. Skin-coloured or brownish-red infiltrates. Sharply defined nodules (= leprosy), a few millimetres to centimetres in size, which develop from maculae or in normal skin, especially at pressure points. Dryness (ichthyosis of the legs), anhidrosis, alopecia, anaesthesia. Ulcerations and perforations are possible (lepromatous gummae), then there is an increased risk of secondary infection.

Facies leontina: Large-area infiltrates and leprosy in the face, leaving out the skin folds. Keratoconjunctivitis, enlargement of the earlobes, hair loss of the eyelashes and lateral eyebrows(madarosis).

Diffuse lepromatosis is characterized by a generalized waxy infiltration of the skin. Alopecia of eyelashes, eyebrows and scalp, see below Alopecia lepromatosa. Infestation of mucous membranes:

  • Nasal mucosa with chronic rhinitis, destruction of the nasal septum with development of a characteristic saddle nose; laryngeal mucosa with purulent laryngitis and respiratory distress, and
  • Eyes with severe damage due to infiltration, which can lead to lagophthalmus (symptom of insufficient active eyelid closure, resulting in widening of the eyelid crease), visual impairment and blindness
  • and nerves with paralysis and loss of sensitivity.

Visceral involvement: Adenopathy, hepatosplenomegaly, orchitis, epididymitis (risk of sterility), osteitis, cachexia.

Note: In this form of leprosy, so-called leprosy reactions are observed.

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Lepromin reaction negative, masses of pathogens in the leprosy cells, bacteremia (detection: see below leprosy).

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Granulomas rich in foam cells (Virchow and leprosy cells) with masses of leprosy bacteria.

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According to the leprosy.

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  1. Azulay RD et al (2001) Cutaneous cryptococcosis associated with lepromatous leprosy. Int J Dermatol 40: 412-414
  2. Baxt RD (2000) Lepromatous leprosy with drug reaction. Dermatol Online J 6: 9
  3. Daniel E et al (2003) Ocular complications in incident relapsed borderline lepromatous and lepromatous leprosy patients in south India. Indian J Ophthalmol 51: 155-159
  4. Moreno-Gimenez IC (2000) Lepromatous leprosy in an HIV-positive patient in Spain. J Eur Acad Dermatol Venereol 14: 290-292Sharma
    G et al (2019) Mycobacterium lepromatosis Lepromatous Leprosy in US Citizen Who Traveled to Disease-Endemic Areas. Emerg Infect Dis 25:389-390.
  5. Thappa DM et al (2002) Localized lepromatous leprosy presenting as a painful nodule in a muscle. Indian J Lepr 74: 237-242
  6. Thappa DM (2000) Lepromatous leprosy masquerading as molluscum contagiosum. Indian J Lepr 72: 495-498


Please ask your physician for a reliable diagnosis. This website is only meant as a reference.


Last updated on: 29.10.2020