Q: I am 31 years old and have a question, which confuses me every time. When I was 9 years old my mother has seen one white patch on my hand. It had no sensation that time so we went to one leprosy expert and he said that it is curable. I then started taking medicines for next five years. Now everything is ok and I don't have a white patch. The doctor had confirmed that I didn't have leprosy. I am still worrying if I have leprosy?

A:You could have been suffering from paucibacillary leprosy. Paucibacillary Hansen’s disease is characterised by one or more (light coloured) hypopigmented skin lesions and anaesthetic patches, i.e. damaged peripheral nerves which have been attacked by the human hosts immune cells. Sensory loss is a typical feature of leprosy. The skin lesion may show loss of sensation to pin pick and/or light touch. Thickened nerves mainly peripheral nerve trunks constitute another feature of leprosy. A thickened nerve is often accompanied by other signs as a result of damage to the nerve. These may be loss of sensation in the skin and weakness of muscles supplied by the affected nerve. Leprosy is confirmed if a person shows any one or more of the following 4 signs: 1. Pale or reddish patches on the skin, with definite loss of sensation. 2. Involvement of the nerves, shown by nerve enlargement and loss of feeling in hands or feet. 3. The presence of leprosy bacilli on slit skin smear examination. 4. A skin biopsy may show characteristic granulomas (mixed inflammatory cell infiltrate in the deeper layers of the skin, the dermis) and involvement of the nerves.