 Welcome back to our meds smarter lecture series where we're taking a smarter approach to preparing future physician Before we get started if you'll take just a quick minute and click that like button and also Subscribe and turn the bell on so that you'll be notified when we post new videos and let's finish up our discussion of Grand positive bacteria with the disease of leprosy leprosy is caused by The bacteria mycobacterium leprae and it causes what we also know as Hansen's disease leprosy specifically infects the skin and superficial nerves Oftentimes it follows a glove and stocking pattern where we lose sensation in our Hands and our feet or our gloves and stockings go and we can't grow leprosy in vitro So like we said earlier mycobacterium leprae is what causes leprosy and mycobacterium leprae is an acid-fab Bacillus that likes cool temperatures. So one of the places that we can see these often in the United States is going to be in armadillos We diagnose a leprosy infection with one of two things the skin biopsy or a Tissue PCR and as you can see in this picture These are some of the cutaneous lesions that we can see with leprosy. This is on the thigh of a patient And as far as leprosy goes there are about two different forms that you can see And a lot of times both of them will appear, but they'll temporarily fall between these two extremes Before they kind of congeal back together. So there's the lepromatis and the tuberculoid forms for leprosy The lepromatis form presents diffusely over the skin with a leonine or a lion-like face And you can also remember that the lion-like face is for a lepromatis So as you can see with this picture here on the left This patient kind of has that lion look to his face that is classic characteristic of the lepromatis leprosy For tuberculoid, it's limited to just some hypo aesthetic or hairless skin pigments. So you see some hairless and White colored skin lesions that's going to be more of your tuberculoid form. The lepromatis form is communicable More so because of its high bacterial load, whereas the tuberculoid form While it can be passed on it has a low bacterial load Which makes it less likely to be passed on to people in the surrounding areas Lepromatis is characterized by low cell mediated immunity with a large TH2 cell response Whereas tuberculoid is a high cell mediated immunity, mostly of the TH1 type response there The lepromatis is the most lethal form. So you think lepromatis Lion-like lethal and to treat them we treat them differently. So for our tuberculoid form We're going to treat with dapsone and rifampin whereas with our lepromatis side. We're going to lose. We're going to use clofazazim If you found this material helpful for your studying, please like and consider subscribing to the channel Also share this video so that more people can benefit from it like you have