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  1. Cardinal Signs of leprosy are as given by the WHO include
    1. Anaesthetic patch or suspicious area of anaesthesia
    2. Peripheral nerve enlargement  
    3. Presence of Acid-fast bacilli in slit skin smears
  2. Classification
    1. Pauci-bacillary (PB) single lesion leprosy 1 skin lesion
    2. Pauci-bacillary (PB) 2 to 5 skin lesions
    3. Multi-bacillary (MB) more than 5 skin lesions
      Neurological assessment and slit-skin smears along do not contribute to this classification.
  3. In Indian Classification of 1955, leprosy is divided as:
    1. Non lepromatous (maculo anaesthetic, tuberculoid and polyneuritic),
    2. Intermediate (indetermiante, Borderline),
    3. Lepromatous.
  4. Ridley- Jopling Classification in 1966 Is Based on the Degree of Specific Cell Mediated Immunity.
    1. Tuberculoid leprosy (TT),
    2. Borderline tuberculoid BT),
    3. Mid borderline (BB),
    4. Borderline lepromatous (BL),
    5. lepromatous leprosy (LL) are five major groups.
It is a clinico bacteriological histologic and immunologic classification that encompasses all the parameters of disease.
Two polar types of Leprosy
Tuberculoid Lepromatous
•  Less severe and minimally infectious
•  Associated with HLA DR-2
•  Skin lesions are asymmetric in distribution
•  Lesions are less in numbers
•  Confined to skin & peripheral nerve (M.C. nerves involved are ulnar, post auricular, peroneal and post tibial) 
•  One or a few hypopigmented, hypo esthetic macule or plaque
•  Nerve involvement is due to external compression by granuloma
•  AFB are generally absent or few in number
•  CMI present
•  Normal Humoral response
•  Lesions have granulomatous inflammation with predominance of CD4 + cells, IL-2, IF-y and IL - 12
•  Lepromin test (+ )ve
•  Antibodies to M. leprae phenolic glycolipid-I (PGL-l) are less common (60%)
•  More severe and maximally infectious
•  Associated with HLA-MT-1, HLA-DQ-1
•  Symmetric distribution
•  More in numbers
•  All organ systems except Lungs and C.N.S
•  Multiple skin nodules or raised plaques.
•  Nerve involvement is due to direct invasion of bacilli
•  Multiple bacilli within histiocytes (lepra or virchow cells) and out side the cells.
•  CMI absent
•  Exaggerated humoral response with hypergamma globulenemia and reverse A/G ratio
•  Non granulomatous with predominance of CD8 + cells, IL-4, IL-5 and IL-10
•  Lepromin test (- )ve
•  Antibodies to PGL-1 are more common (95%+)

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