Answer 54
In lepromatous leprosy
False a. neuropathy occurs before skin lesions
False b. skin lesions are typically anaesthetic
True c. skin lesions are typically symmetrical
False d. the lepromin test is positive
True e. leonine facies occurs
Skin lesions are present before neuropathy develops. The initial skin lesions are small hypopigmented macules which are not anaesthetic. They are multiple and symmetrical. Later papules, nodules and diffuse dermal thickening may occur. In untreated cases the patient may develop the characteristic leonine facies.
Affected nasal cartilage may collapse causing a saddle-nose deformity.
Neuropathy. Peripheral nerve trunks (especially median, ulnar, sural, common peroneal) may be thickened and palsied.
Eyes. The eyes may be affected by iritis or may be traumatised because of seventh nerve palsy or corneal sensitivity.
