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Leprosy

Alexandro Valent Homalessy


Imelda Mauti
Apa itu lepra ?

Merupakan peyakit infeksi kronik yang


disebabkan oleh Mycobacterium Leprae
Klasifikasi ilmiah
Kingdom: Bacteria
Filum: Actinobacteria
Ordo: Actinomycetales

Subordo: Corynebacterineae

Famili: Mycobacteriaceae

Genus: Mycobacterium
Spesies: M. leprae
Nama binomial
Mycobacterium leprae
Hansen, 1874
Karakteristik
etc
Karena tebalnya lapisan lilin pada bakteri -> pewarnaan dilakukan dengan
carbol fuschin, tidak dengan pewarnaan gram tradisional
Basil lepra dalam suasana panas dan lembab dapat tetap hidup selama 9-16
hari. Jika terkena sinar matahari secara langsung dapat bertahan hidup
selama 2 jam, terhadap sinar u.v. hanya dapat bertahan 30 menit
M.leprae merupakan kuman yang bersifat obligat intra-seluler dan dapat
bertahan terhadap aksi fagositosis oleh karena mempunyai dinding sel yang
sangat kuat dan resisten terhadap aksi lisosim
Hidup dalam sel (Intrasel) -> terutama jaringan yang bersuhu dingin seperti
kulit, mukosa hidung, saraf tepi (terutama sel Schwann)
Mycobacterium leprae tidak dapat dikultur dalam media buatan
Type I

An acid fast bacillus


Mochammad Hatta
Tipe Indeterminate (I)

Solitary, ill-defined,
faintly hypopigmentated
macule, with partial loss
of sensation

Mochammad Hatta
Type TT

Acid fast stain failed to demonstrate the presence of AFB


Mochammad Hatta
Tuberculoid (TT)

Well-defined hypopigmened
lesion with dry surface and
moderately raised granular
margins; completely
anaesthetic

Mochammad Hatta
An AFB
(type BT)

Mochammad Hatta
Borderline Tuberculoid (BT)

Well-defined, dry and rough-


surfaced plaque on cheek,
insensitive to touch and
pain; note papulo-nodular
lesions near eye and upper
lip

Mochammad Hatta
Type BB
Moderate
number AFB

Mochammad Hatta
Borderline (BB)

Fairly extensive succulent


plaque with sharply
demarcated clear central
area; peripheral edges
sloping into surrounding
normal skin; central
univolved area anaesthetic

Mochammad Hatta
Type BL

Numerous AFB

Mochammad Hatta
Borderline Lepromatous (BL)

Numerous and widespread


borderline-type plaques,
annular lesions, papules and
macules; center of large
lesions show some loss of
sensation

Mochammad Hatta
Type LLs

Numerous AFB

Mochammad Hatta
Sub-polar Lepromatous (LLs)

Symmetrical infiltration
and erythematous
macules , with an
unusual borderline-type
plaques on the left
buttock

Mochammad Hatta
Type LLp

Numerous AFB in
globi formation

Mochammad Hatta
Polar Lepromatous (LLp)

Advanced lepromatous
leprosy with diffuse
infiltration coupled with
nodules over eyebrows,
cheeks, ala nasae and chin,
as well as lobes

Mochammad Hatta
ENL

Few degerated
AFB within
reactional site

Mochammad Hatta
Erythema Nodosum Leprosum (ENL)

Typical, moderately
severe, cutaneous and
subcutaneous,
inflammatory ENL
lesions; some are
undergoing pustulation
and ulceration

Mochammad Hatta
Histoid lesion

Packets of large
number of AFB

Mochammad Hatta
Histoid Nodule

Florid and very discrete


histoid lesions in a DDS-
treated patient

Mochammad Hatta
Sumber

Staf Pengajar FKUI. 1993. Mikrobiologi Kedokteran : Edisi Revisi. Jakarta :


Bina Rupa Aksara.
Photo : Slide Mycobacterium Leprae, Prof. Moch. Hatta FK UNHAS
Slide Leprosy, dr. Anselma, Sp.KK FK UNDANA
Terima Kasih