Clinical presentation and histopathology of childhood leprosy

Background: Leprosy is one of the oldest diseases of mankind. It is well-documented in children with an incidence of 13.3%, as immune system is not fully developed. 75% of cases regress spontaneously without treatment.
Aim: To study incidence, duration, spectrum, reactions, deformity, slit skin smear (SSS) and skin, and nerve biopsy in childhood leprosy.
Materials and Methods: Leprosy cases from 0 to 14 years age who attended Department of Dermatology and Leprosy of Government General Hospital, Chennai, were collected for 2 years (study period).
Results: During the study period of 2 years, total numbers of childhood leprosy cases were 46. Most number of cases was seen in 10-14 years age group - 36 cases (78.3%). Most common spectrum is borderline tuberculoid 27 cases (58.7%). Percentage of cases in household contact was 19.6%. Type 1 reaction was seen in 3 children. Type 2 reaction was not seen. The deformity was seen in 5 children. SSS was positive in only 4, all of them were borderline leprosy cases.
Conclusion: Leprosy still occurs in children in sizable and constant proportion, even though the prevalence rate has reduced below one per thousand and we are in the run for total eradication of leprosy.