Homepage site français hospital structure newsletter ophthalmology leprosy control clinic prayer RIBA project  development Illness and Treatment The state of a patient's skin may indicate leprosy although it is a disease of the nerves. In particular there may be pale marks on the skin. In addition there is no sweat on the areas covered by the marks nor is there the grease found on a normal skin. When there are five marks or less the illness is classified as paucibacillary leprosy while six marks or more signify the multibacillary form of the disease. In principle the latter is more severe although it is caused by the same bacillus. The diagnosis follows these criteria because it relates to the treatment. Treatment for six months is required for pauci- bacillary leprosy while a multibacillary diagnosis requires treatment for a year. Control is necessary because the regular taking of medicine is essential. Sometimes it is necessary to begin the treatment again when patients, who think that they have been cured, fail to finish their course of treatment.  An important test is the sensitivity of the skin as well as that of the soles of the feet and the palms of the hand. Very often there is a bilateral or symmetric loss of sensation. Thus the same toes on both feet may be numb.  Centre page 1 Rhinitis is one of the signs of multibacillary leprosy. That is to say that bacilli are present in the nose with its respiratory passages. It is thought that leprosy is transmitted by sneezing, but the more serious consequence is the destruction of the patient's nose and associated bone. A control programme is necessary so as to screen patients before they become handicapped. The assessment of levels of sensation is made either with a pen or with a fine piece of plastic of which the flexibility is predetermined on the basis of its thickness.  Control and screening are complementary.