**4. Classification of leprosy**

Classification of leprosy according to immunity by Ridley and Jopling (**Figure 4**) consists of a 5 group-system based upon the clinical, histopathological, immunological and bacilloscopic factors:

	- Granulomatous lesions
	- Th1 (cell-mediated) immune chapter
	- Th2 (an anti-inflammatory cytokine) characteristics
	- Multiplication of pathogen in macrophage phagosomes.

**161**

groups:

**Figure 4.**

*Leprosy classification.*

barrier [7].

leprosy.

membranes.

milk, and insect bites.

*Leprosy in the Modern Era*

*DOI: http://dx.doi.org/10.5772/intechopen.91450*

WHO classification [6] according to the number of lesions consists of three

Leprosy is transmitted via close and prolonged contact amongst healthy individuals and a bacillus-infected patient through inhalation of the bacilli contained in nasal secretions or Flügge droplets. The main route of transmission is the nasal mucosa. Leprosy, similar to other infectious diseases is a consequence of pathogen invasion of the host organism and transposition of the immunological

Transmission can occur by skin erosions, blood, vertical transmission, breast

In the individuals with the solid immune system, leprosy is presented in tuberculoid form (solitary papules and plaques). Such skin changes may form erythema-

In the case of a defected immune system, lepromatous leprosy is presented with

an impaired T-cell immunity leading to anergy. Clinically, this manifestation is shown as multiple red-brown-nodular infiltrate (lepromas) in the skin and mucous

In infected individuals, there is a transitional period of nasal release of bacilli. The presence of specific DNA sequences of M. leprae in swabs or nasal biopsies and seropositivity suggest the carrier plays a role in the transmission of

tous plaques with raised borders and an annular appearance.

1.Paucibacillary single-lesion leprosy (single skin lesion)

3.Multibacillary leprosy (more than 5 skin lesions)

2.Paucibacillary leprosy (2–5 skin lesions)

**5. Clinical and laboratory diagnosis**

*Pathogenic Bacteria*

Higher levels of NGF are observed in the lepromatous forms, while lower NGF

High levels of NGF are associated with lepromatous and decreased levels are

Classification of leprosy according to immunity by Ridley and Jopling (**Figure 4**) consists of a 5 group-system based upon the clinical, histopathological,

levels are present in tuberculoid forms.

associated with tuberculoid forms [5].

immunological and bacilloscopic factors:

**4. Classification of leprosy**

**Figure 3.**

*Pathogenesis of leprosy [4].*

1.Borderline-tuberculoid

2.Borderline-lepromatous

3.Borderline-borderline

• Granulomatous lesions

• Th1 (cell-mediated) immune chapter

• Th2 (an anti-inflammatory cytokine) characteristics

• Multiplication of pathogen in macrophage phagosomes.

4.Tuberculoid

5.Lepromatous

**160**


#### **Figure 4.** *Leprosy classification.*

WHO classification [6] according to the number of lesions consists of three groups:

1.Paucibacillary single-lesion leprosy (single skin lesion)

2.Paucibacillary leprosy (2–5 skin lesions)

3.Multibacillary leprosy (more than 5 skin lesions)
