Harboe (Miller & Love, 1989, P. 318) reports that the disease leprosy, which is infrequently also known as Hansen's Disease, is caused by invasion of Mycobacterium leprae, an obligate intracellular parasite occurring in macrophages and other cells, with three resulting categories. These categories parallel the Ridley-Jopling classification of leprosy and, thus, are internationally accepted. The first category, indeterminate leprosy, typically heals spontaneously, while tuberculoid leprosy contains few lesions having bacilli and lepromatous leprosy has multiple lesions in which bacilli grow uninhibited due to " . . . defective cell-mediated immunity." In addition to the presentation of lesions in the second and third categories, sufferers of leprosy as well manifest nerve damage that results in the majority of deformities often associated with this disease. Lechat (Miller & Love, 1989, P. 324) notes that approximately 25% of all infected individuals who do not receive early intervention develop anesthesia and/or severe deformities of the hands and feet. Mansfield (1989) notes that trophic ulceration, which is succeeded by persistent erythema, occurs in denervated extremities due to a series of low-pressure traumas that are often initially tolerated, as is the case in diabetes mellitus. With the absence of feedback from pain and the existence of low-grade inflammation, autolysis of the skin occurs, resulting in secondary infection, enlargement of the ulceration with the potential for osteomyelitis, the loss of digits, the partial or full loss of ears, the loss of the tip of the tongue, and even, for males, the penis, etc.
Lechat (Miller & Love, 1989, p. 324) reports that the disease leprosy has struck approximately 15 million, although estimates vary for several reasons. Foremost is that there are relatively few population surveys conducted in those countries where leprosy presents; there are many cases that go undiagnosed for...