Childhood Leprosy in the Light of Global Leprosy Strategy 2016-2020

Achieving zero grade 2 disability among children diagnosed with leprosy was one of key targets identified in Global Leprosy Strategy (2016–2020). Considering this we decided to study the clinico-epidemiological features of childhood leprosy in the post elimination era, with special reference to disabilities, over a period of 10 years (2006 to 2015 ). These childhood cases were among the patients attending the leprosy clinic of Govt. Medical College Thrissur, a tertiary care hospital in South India. Data from the case records of all patients with leprosy aged < 15 years registered in our leprosy clinic were compiled and analysed. Out of 409 leprosy patients registered, 24 (5.9% ) were children < 15 years. In the first half of the study period (2006-2010) there were 13 childhood cases (6.2%) and in the second half (2011-2015) there were 11 (5.5%). Males (10) out numbered females (3) in the first half of study period where as in the second half, the sex ratio was almost equal (M=5, F=6). The commonest age group affected was 6 - 10 years during both halves of the study period. In both halves of the study period, majority had skin lesions of less than one year duration at the time of presentation. The commonest type of leprosy was borderline tuberculoid (n=19; 79%). All patients were smear negative for acid fast bacilli. Four patients (16.7%) had peripheral nerve thickening but none had visible deformity. Percentage of childhood leprosy (5.9%) in our study is lower than the national (8.94%) and state (6.97%) NLEP figures for the year 2015-2016. Absence of Grade 2 disability is a unique feature of our study. Zero Grade 2 deformity observed in our study is consistent with the Kerala and Tamil Nadu state NLEP data for the year 2016-2017. Zero Grade 2 disability in all our patients possibly points to the early treatment seeking behaviour of population in Kerala leading to early diagnosis and prompt management of lepra reactions.

Unilateral generalized hypertrichosis in proteus syndrome.

A young lady was found to have hemihypertrophy, scoliosis, subcutaneous swellings, patchy dermal hypoplasia, plantar hyperplasia and macrodactyly. These suggested a diagnosis of Proteus syndrome. She was also having unilateral generalized hypertrichosis. The association of Proteus syndrome and unilateral generalized hypertrichosis has not been reported in the literature.