An individual may present with skin lesions or symptoms suggestive of nerve damage, but the cardinal signs may be absent or doubtful; such a person should be called a leprosy suspect in the absence of any immediately obvious alternative diagnosis. Such individuals should be informed about the basic facts of leprosy and advised to see you again if their symptoms persist for more than six months, or if at any time the symptoms worsen. In these circumstances, suspect cases should be referred to health facilities with more capacities for diagnosing leprosy. Use Box 18.2 to help you take a history from a person you suspect may have leprosy.
Box 18.2 Checklist for history-taking from leprosy suspects
Make the individual comfortable, and ask for the name, age, sex, address, etc. Take a history of the present illness by asking:
- How long has the skin patch been there? How did it start? Has it changed? (Leprosy patches usually appear slowly.)
- Do the patches itch? Is there pain? (Leprosy patches do not itch and are not usually painful.)
- Does the person have unusual sensations in the hands or feet, such as numbness, tingling or burning feeling? (Unusual sensation in the hands or feet, chronic ulcers and eye problems are all signs of leprosy.)
- The nature of the first lesion or symptom, including the time (when) and site (where) the lesion first appeared and the subsequent development of the disease.
- Did the person have any treatment for leprosy in the past? If yes, which type, and for how long?
- Is there any other person in the family with similar symptoms or signs, or who has been treated or is being treated for leprosy?