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Leprosy — SCE Infectious Diseases MCQ

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ModerateTropical & Imported InfectionsLeprosySCE Infectious Diseases

A 30-year-old man from Papua New Guinea presents with multiple hypopigmented anaesthetic macules across his trunk and limbs, bilaterally symmetric. Slit-skin smear from an earlobe shows numerous acid-fast bacilli (bacterial index 5+). Nerve thickening is present. What classification and treatment regimen applies?

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Correct answer: B — Multibacillary leprosy; Dapsone plus Rifampicin plus Clofazimine for 12 months

Multiple skin lesions (>5) with high bacterial index (5+) on slit-skin smear indicates multibacillary (lepromatous/borderline lepromatous) leprosy. WHO MDT regimen: Dapsone 100 mg daily (self-administered) plus Clofazimine 50 mg daily (self-administered) plus 300 mg monthly (supervised) plus Rifampicin 600 mg monthly (supervised) for 12 months. G6PD testing before Dapsone, monitoring for type 1 and type 2 (ENL) reactions, and counselling about Clofazimine skin discolouration are all important.

Reference: WHO 2024 – Leprosy guidelines; NICE CKS 2024 – Leprosy