The diagnosis and the classification of leprosy is made on clinical grounds. Skin smear result confirm the clinical classification. It is important to remember that all types of leprosy are caused by only one kind of bacillus: Mycobacterium leprae. In every leprosy patient these bacilli are present somewhere in the body even if skin smears are negative. Leprosy is classified into two main groups depending on the number of bacilli present in the body. Patients with many bacilli belong to the multi bacillary group, while those with few bacilli belong to the paucibacillary group. These groups are subdivided into four main types which are:

Table: Classification of Leprosy (Ridley-Jopling System)

Patients with tuberculoid leprosy are loss infectious (due to few bacilli) but are more likely to suffer paralysis of peripheral nerves.

Treatment guidelines

These are given according to the National TB and Leprosy Programme:

1. Dapsone monotherapy

2. Multiple Drug Therapy (MDT)

Recommended to prevent or treat drug resistance and to cure patients in a shorter period of time. For multi-bacillary (BL-L) patients give Rifampicin and Isoprodian (Isoniazid 175 mg, Prothyonamide 175 mg, Dapsone 50 mg) daily for 1 month (4 weeks) under supervision followed by Isoprodian daily for 23 months plus a single dose of Rifampicin under supervision every 4 weeks (1 R Isop /23 Isop(R)} or Isoprodian daily for 24 months plus a single dose of Rifampicin under supervision every 4 weeks (24 Isop (R)}.

For paucibacillary (BT-T) patients, give Isoprodian daily for 6 months plus a single dose of Rifampicin under supervision every 4 weeks (6 Isop (R)}.

Table: Dosage adjustment to patient's body weight