Fig. 78.—Nodular leprosy. Advanced stage with ulceration. Leontiasis. (Van Harlingen.)
The glands in the region of the lesions become enlarged but do not tend to suppurate.
Visceral involvements are not common but serious lesions of the liver have been reported.
The course of the disease is essentially chronic and if some intercurrent affection does not carry off the patient, the end comes in a cachexia in about ten years, the temperature gradually falling and a state of somnolence ushering in the end.
When nerve leprosy sets in upon a nodular type the life of the patient seems to be prolonged.
Nerve Leprosy
A Typical Case.—The prodromal manifestations are characterized by the results of irritation of the granulomatous tissue upon the nerve fibers and are chiefly neuralgic pains or signs of sensory disturbances as formication, paraesthesias, etc. In particular, are the ulnar, peroneal and facial nerves attacked, the process very rarely extending above the knee or elbow.
Fig. 79.—Nerve leprosy. Perforating ulcer of the foot. (U. S. Naval Medical Bulletin.)