(1998; 28 pages)
Classification of leprosy
For treatment purposes patients can be divided into three groups: paucibacillary single-lesion leprosy, paucibacillary leprosy and multibacillary leprosy. Skin smears were originally used to distinguish between paucibacillary and multibacillary leprosy. However, because services for processing skin smears are not always available, and also because their reliability is often doubtful, in practice most leprosy programmes classify and choose the appropriate regimen for a particular patient using clinical criteria, which uses the number of skin lesions and nerves involved to classify leprosy patients into paucibacillary single-lesion leprosy (one skin lesion), paucibacillary leprosy (2-5 skin lesions) and multibacillary leprosy (more than five skin lesions).
When skin smears are available and are dependable, any patient with a positive skin smear, irrespective of the clinical picture, must be classified as multibacillary leprosy and must be treated with the multidrug therapy regimen for multibacillary leprosy.