Nursing Guide to Leprosy: Nursing Diagnosis, Interventions, & Care Plans

Leprosy, also known as Hansen disease, is a chronic infectious disease caused primarily by Mycobacterium leprae and less commonly by Mycobacterium lepromatosis. The organisms have a predilection for cooler areas of the body and commonly affect the skin, peripheral nerves, upper respiratory tract mucosa, and eyes. The clinical hallmark is a combination of skin lesions and peripheral neuropathy that can progress to sensory loss, muscle weakness, deformities, and disability if not recognized and treated early. 

Despite being curable, leprosy remains clinically significant because delayed diagnosis and inflammatory “reactional states” can cause irreversible nerve damage. Nurses play a central role in early recognition, functional assessment of nerves, monitoring for adverse effects of multidrug therapy, prevention of secondary injuries related to sensory loss, and patient-centered education that reduces stigma and supports adherence to prolonged treatment.  

Nursing care also frequently involves coordination with specialists such as infectious disease, dermatology, neurology, ophthalmology, rehabilitation services, and wound care teams. 

Leprosy exists on an immunologic spectrum. Host cell-mediated immunity strongly influences bacterial burden and manifestations: 

• Paucibacillary (PB) disease generally reflects stronger cellular immunity, fewer lesions, lower bacterial load, and often more localized nerve involvement.
• Multibacillary (MB) disease reflects weaker cellular immunity, higher bacterial load, more diffuse lesions, and a higher risk of systemic complications. 

In many clinical settings, PB and MB classification guides treatment duration and medication regimen. A second, widely used clinical framework is the Ridley-Jopling spectrum (tuberculoid, borderline forms, and lepromatous), which aligns with immunologic response and helps anticipate complications such as reactional episodes. 

A unique feature of leprosy is the tendency to cause peripheral neuropathy early and sometimes subtly. Sensory impairment reduces protective pain perception and can lead to repeated trauma, burns, pressure injuries, and plantar ulcers.  

Motor nerve involvement may cause muscle weakness and deformities such as claw hand or foot drop. Autonomic nerve involvement may reduce sweating and lead to dry, cracked skin that is prone to fissures and infection. Because disability in leprosy is often preventable, nursing assessment and education are as important as antimicrobial therapy. 

Leprosy isn’t highly contagious in routine social contact. Most people have natural immunity, and transmission typically requires prolonged, close exposure to untreated cases. Effective therapy rapidly reduces infectivity. These facts are essential for reducing fear and stigma and for promoting respectful, evidence-based counseling. 

Etiology and epidemiology 

Causative organisms 

• Mycobacterium leprae is the principal cause of leprosy worldwide. It is an acid-fast bacillus that replicates slowly and cannot be cultured on standard artificial media.
• Mycobacterium lepromatosis is a related species that can also cause Hansen disease in humans. 

The organism’s preference for cooler body areas explains frequent involvement of the skin, superficial peripheral nerves, nasal mucosa, and anterior eye structures. 

Transmission 

Leprosy transmission is most commonly associated with respiratory droplets and prolonged exposure to untreated individuals with multibacillary disease. Exact transmission dynamics vary by setting, but key points for nursing practice include: 

• Prolonged, close contact is generally required for transmission.
• Untreated multibacillary disease is considered more infectious than paucibacillary disease.
• Treatment reduces infectivity substantially, and people on appropriate multidrug therapy are typically considered noninfectious after initiating therapy, according to many public health programs.
• In some geographic regions, zoonotic transmission has been associated with armadillos, and exposure history may be relevant in areas where armadillos carry M. leprae. 

Leprosy isn’t spread by casual contact such as handshakes, hugging, sharing utensils, or sitting near someone. Reinforcing these facts supports psychological safety and reduces discrimination. 

Incubation period and natural history 

Leprosy has a long incubation period, commonly measured in years. This contributes to delayed presentation, difficulty recalling exposures, and diagnostic challenges in nonendemic regions.  

The disease may begin with subtle hypopigmented or erythematous patches with diminished sensation, or with neuropathic symptoms such as numbness, tingling, or weakness. 

Untreated disease can progress to: 

• Worsening peripheral neuropathy and nerve thickening
• Muscle weakness and deformity
• Chronic skin lesions, nodules, or diffuse infiltration
• Eye involvement (keratitis, uveitis, lagophthalmos) with risk of visual impairment
• Nasal involvement (chronic congestion, epistaxis) and, in advanced cases, structural changes
• Reactional states (acute inflammatory episodes) that can cause rapid nerve injury 

Epidemiology 

Leprosy occurs worldwide, with higher prevalence in certain regions of Asia, Africa, and Latin America. Many countries have achieved substantial reductions in prevalence through widespread availability of multidrug therapy, but ongoing transmission persists in some areas, and cases continue to occur in low-prevalence countries due to migration, travel, and occasional zoonotic exposure. 

Nursing implications of epidemiology: 

• In nonendemic settings, leprosy may be misdiagnosed as eczema, psoriasis, tinea, vitiligo, neuropathy from diabetes, or autoimmune conditions. Maintaining diagnostic curiosity is important when skin lesions have sensory changes or when neuropathy is asymmetric and involves cooler body parts.
• In endemic or higher-incidence communities, contact screening, early referral, and patient education can reduce disability and support prevention efforts.
• Social determinants of health, including crowded living conditions, limited access to care, malnutrition, and stigma-related delays, can increase risk of transmission and late presentation. 

Risk factors 

• Household or close contact with an untreated person with multibacillary leprosy
• Residence in or prolonged travel to higher-incidence regions
• Exposure to armadillos in regions where zoonotic transmission is documented
• Immunologic factors that influence susceptibility (not fully predictable clinically) 

Coexisting conditions such as diabetes or peripheral vascular disease can worsen outcomes by compounding neuropathy, impairing wound healing, and increasing infection risk. 

ICD-10 code 

ICD-10-CM codes for leprosy are found primarily in category A30 (Leprosy [Hansen disease]). A commonly used related code is B92 (Sequelae of leprosy) for residual effects after active infection has resolved. 

Common ICD-10-CM codes include: 

• A30.0 Indeterminate leprosy
• A30.1 Tuberculoid leprosy
• A30.2 Borderline tuberculoid leprosy
• A30.3 Borderline leprosy
• A30.4 Borderline lepromatous leprosy
• A30.5 Lepromatous leprosy
• A30.8 Other forms of leprosy
• A30.9 Leprosy, unspecified 

Sequelae: 

• B92 Sequelae of leprosy 

Tip: Accurate coding depends on provider documentation of the clinical type (for example, tuberculoid vs lepromatous), disease activity, and complications. Nursing documentation is valuable when it clearly describes lesion characteristics, sensory and motor findings, nerve function trends, eye symptoms, and disability level, as these details support specificity and care planning. 

Diagnosis 

Cardinal clinical features 

Many clinical programs emphasize three classic findings. A diagnosis is strongly supported when one or more of the following are present: 

1. Skin lesion(s) with definite sensory loss (decreased light touch, temperature, or pain)
2. Thickened or enlarged peripheral nerve(s) with sensory and or motor impairment
3. Acid-fast bacilli on slit-skin smear or tissue biopsy 

In practice, especially in low-prevalence settings, diagnosis often requires a combination of clinical evaluation, dermatologic or neurologic examination, and confirmatory testing. 

Clinical presentation by spectrum 

Paucibacillary or tuberculoid end 

• Few (often one to five) hypopigmented or erythematous plaques
• Well-demarcated lesions with dry surface and reduced hair growth
• Marked sensory loss in lesions
• Asymmetric peripheral nerve involvement (for example, ulnar, median, posterior tibial, common peroneal)
• Higher risk of type 1 (reversal) reactions affecting nerves 

Multibacillary or lepromatous end 

• Numerous lesions, nodules, papules, diffuse infiltration
• More symmetric distribution
• Possible facial involvement, nasal congestion or epistaxis
• Diffuse neuropathy may occur later, including glove-and-stocking sensory loss
• Higher risk of type 2 reactions (erythema nodosum leprosum) with systemic symptoms 

Borderline forms 

• Mixed features with unstable immunity and greater likelihood of reactional episodes 

Nursing assessment priorities 

A structured nursing assessment can accelerate diagnosis and prevent disability: 

History 

• Duration and evolution of skin lesions
• Numbness, tingling, burning pain, weakness, clumsiness, foot drop, or hand weakness
• Eye symptoms, including dryness, redness, pain, blurred vision, and photophobia
• Nasal symptoms, including chronic congestion, and epistaxis
• Fever, malaise, tender nodules, joint pain (may suggest reactional states)
• Residence or travel history and contact history
• Occupational and environmental exposures, including armadillo contact when relevant
• Comorbidities affecting neuropathy and wound healing (diabetes, alcohol use disorder, B12 deficiency)
• Pregnancy status and medications, including immunosuppressants 

Physical examination support 

• Full skin inspection in good light: face, ears, trunk, extremities, and pressure points
• Documentation of lesion type: macules, plaques, papules, nodules, diffuse thickening
• Sensory testing on and around lesions: light touch, pain, temperature
• Palpation for nerve enlargement and tenderness (commonly ulnar, radial cutaneous, median, posterior tibial, common peroneal)
• Motor screening: grip strength, finger abduction, thumb opposition, wrist extension, ankle dorsiflexion, toe extension
• Autonomic signs: dry skin, cracks, reduced sweating
• Foot assessment: calluses, fissures, ulcers, deformities, footwear fit
• Eye assessment: eyelid closure, corneal sensation (specialist evaluation often required), redness, discharge 

Diagnostic tests 

Slit-skin smear 

• Samples are taken from standardized sites (often earlobes and active lesions) and stained for acid-fast bacilli.
• More likely positive in multibacillary disease.
• Results can help classify disease burden and guide management. 

Skin biopsy 

• Histopathology can demonstrate granulomatous inflammation, nerve involvement within the dermis, and acid-fast organisms.
• Helpful in indeterminate cases and for differentiating from other dermatoses. 

Nerve biopsy 

• Less commonly performed but may be considered in challenging cases, particularly when neuropathy is prominent and skin findings are minimal. 

PCR and specialized testing 

• Molecular assays may help confirm diagnosis where available, especially in atypical presentations or smear-negative disease. 

Baseline laboratory testing 

While no routine blood test confirms leprosy, baseline labs are important before initiating therapy and for monitoring: 

• CBC with differential
• Liver function tests
• Renal function tests
• Pregnancy testing when indicated
• Glucose or HbA1c if neuropathy or wounds are present 

Classification for treatment 

Many programs are classified as PB vs. MB based on lesion count and or smear results. A common operational approach is: 

• PB: 1 to 5 lesions and smear negative
• MB: 6 or more lesions and or smear positive 

Local protocols may vary, and specialist involvement is recommended. 

Differential diagnosis 

Leprosy can mimic multiple conditions. Differential considerations include: 

• Tinea versicolor or other fungal infections
• Vitiligo or postinflammatory hypopigmentation
• Eczema, psoriasis, lichen planus
• Sarcoidosis
• Cutaneous tuberculosis and atypical mycobacterial infections
• Peripheral neuropathy from diabetes, B12 deficiency, HIV, hypothyroidism
• Vasculitic neuropathy, lupus, or other autoimmune neuropathies
• Syphilis, yaws, or other tropical dermatoses in relevant exposures 

Key distinguishing nursing observations include skin lesions with sensory loss, asymmetric nerve dysfunction, and progressive disability signs. 

Recognition of reactional states 

Reactional episodes can occur before diagnosis, during treatment, or after completion of therapy. Early recognition is critical because reactions can rapidly damage nerves. 

• Type 1 reaction (reversal reaction): acute inflammation of existing lesions, swelling, redness, pain, and neuritis with nerve tenderness or new weakness.
• Type 2 reaction (erythema nodosum leprosum, ENL): tender erythematous nodules with systemic symptoms such as fever, malaise, arthralgias, and possible organ involvement (for example, eyes, testes). 

Nurses should treat new nerve pain, nerve tenderness, sudden sensory changes, or new motor weakness as urgent findings requiring prompt provider evaluation. 

Management 

Leprosy is curable. Management has four interlocking goals: 

1. Eradicate the organism with appropriate multidrug therapy.
2. Detect and treat reactional states promptly.
3. Prevent disability through nerve function monitoring, protective care, and rehabilitation.
4. Address psychosocial needs, including stigma and long-term self-management. 

Antimicrobial therapy 

Multidrug therapy (MDT) is the standard approach to prevent resistance and achieve cure. Regimens vary by national protocol and PB versus MB classification, but commonly include: 

• Rifampicin
• Dapsone
• Clofazimine (commonly included for multibacillary disease and in some protocols for all disease) 

Typical programmatic durations are often: 

• PB: 6 months of MDT (varies by protocol)
• MB: 12 months of MDT (varies by protocol) 

Nursing responsibilities during MDT: 

• Reinforce adherence and the importance of completing therapy even when symptoms improve.
• Screen for adverse effects and drug interactions.
• Coordinate laboratory monitoring as ordered.
• Support access to medications and follow-up appointments.
• Provide anticipatory guidance about expected benign effects (for example, rifampicin may discolor urine and tears). 

Monitoring for common medication adverse effects 

Rifampicin 

• Hepatotoxicity risk, especially with preexisting liver disease or concomitant hepatotoxic agents
• Drug interactions (enzyme induction can reduce effectiveness of many medications, including some anticoagulants and hormonal contraceptives)
• Harmless orange-red discoloration of urine, sweat, and tears
• Gastrointestinal upset 

Nursing actions: 

• Review medication list and alert prescriber to interaction concerns.
• Monitor for jaundice, dark urine beyond expected discoloration, severe fatigue, RUQ pain.
• Reinforce lab follow-up for liver function tests if ordered. 

Dapsone 

• Hemolysis, particularly in G6PD deficiency
• Methemoglobinemia
• Dapsone hypersensitivity syndrome (fever, rash, systemic involvement)
• Anemia and leukopenia in some patients 

Nursing actions: 

• Ensure baseline CBC and G6PD testing if ordered or indicated by protocol.
• Monitor for pallor, dyspnea, cyanosis not improving with oxygen, fatigue, dark urine, rash, and fever.
• Escalate urgently for suspected hypersensitivity syndrome or severe hemolysis. 

Clofazimine 

• Skin discoloration (red-brown to black), which can be distressing and stigmatizing
• Ichthyosis or dry skin
• Gastrointestinal symptoms with higher doses 

Nursing actions: 

• Provide anticipatory counseling about discoloration to support adherence.
• Offer skin care strategies for dryness.
• Assess emotional impact and provide supportive resources. 

Management of reactional states and neuritis 

Reactional states are major drivers of nerve injury and disability. Treatment is usually continued MDT plus additional anti-inflammatory or immunomodulatory therapy as directed. 

Type 1 (reversal) reactions 

• Often managed with corticosteroids when neuritis or function impairment is present.
• Urgency is tied to nerve pain, tenderness, sensory loss progression, and motor weakness. 

Nursing priorities: 

• Frequent nerve function assessment and documentation.
• Immediate escalation for new weakness, severe nerve pain, or rapid sensory loss.
• Monitor corticosteroid adverse effects: hyperglycemia, hypertension, mood changes, infection risk, GI irritation.
• Support gastric protection and bone health strategies per orders and risk profile. 

Type 2 reactions (ENL) 

• Management may include corticosteroids, clofazimine adjustment, and in selected contexts thalidomide (with strict pregnancy prevention due to severe teratogenicity).
• ENL can involve eyes, joints, testes, kidneys, and nerves, and may require hospitalization if severe. 

Nursing priorities: 

• Assess systemic symptoms, such as fever, pain, nodules, eye symptoms, edema.
• Monitor for complications such as uveitis or neuritis.
• Provide pain control and supportive care.
• Reinforce pregnancy prevention measures and monitoring when teratogenic medications are prescribed. 

Disability prevention and rehabilitation 

Antimicrobial cure does not automatically reverse nerve damage. Disability prevention is a core component of care. 

Key strategies: 

• Regular nerve function testing (sensory and motor) to detect early neuritis
• Protective care for anesthetic limbs: daily inspection, protective footwear, avoidance of burns and trauma
• Wound prevention and management: callus care, offloading, moisture balance, infection surveillance
• Hand and foot exercises to maintain strength and range of motion
• Splints and orthotics to prevent contractures and improve function
• Eye protection: lubrication, eyelid taping at night if lagophthalmos, prompt ophthalmology referral for pain or redness
• Surgical interventions in selected cases: nerve decompression, tendon transfer, correction of deformities, management of chronic ulcers 

Nurses often coordinate referrals to physiotherapy, occupational therapy, podiatry, orthotics, and ophthalmology, and reinforce long-term self-care routines. 

Infection prevention and public health considerations 

In most clinical environments, routine standard precautions are appropriate. Additional isolation isn’t typically required solely for leprosy when effective treatment is initiated, but facility policies and public health guidance should be followed. 

Public health activities may include: 

• Contact assessment and education for household members
• Screening of close contacts for skin lesions and sensory changes
• In some programs, targeted prophylaxis for contacts may be implemented per local guidance 

Psychosocial care and stigma reduction 

Leprosy has a heavy historical and cultural stigma. Patients may fear isolation, job loss, or rejection. Nurses can reduce harm by: 

• Using respectful language and focusing on curability
• Explaining realistic transmission risks
• Offering mental health support and community resources
• Supporting disclosure planning when relevant, emphasizing patient autonomy and confidentiality
• Assessing for depression, anxiety, and social isolation 

Nursing care plan 

Nursing considerations 

• Early detection prevents disability: Treat new sensory loss, nerve pain, or weakness as urgent, even if skin findings appear stable.
• Therapy is prolonged: Adherence support is essential, particularly when symptoms improve early or when visible medication effects (for example, skin discoloration) cause distress.
• Comorbid neuropathy matters: Diabetes, alcohol-related neuropathy, and nutritional deficiencies can complicate assessment and wound risk.
• Eye involvement can be silent: Corneal sensation may be reduced, so absence of pain does not exclude injury. Any redness, blurred vision, or photophobia warrants prompt evaluation.
• Stigma-sensitive care is part of evidence-based practice: Clear communication about low contagiousness and curability improves outcomes.
• Interdisciplinary coordination is routine: Expect collaboration with dermatology, infectious disease, neurology, ophthalmology, wound care, and rehabilitation. 

Assessment 

Subjective data 

• Onset and progression of skin lesions, numbness, tingling, burning pain
• Weakness: grip strength changes, tripping, difficulty with buttons, dropping objects
• Painful, tender nodules; fever; malaise; joint pain (reactional states)
• Eye symptoms: dryness, redness, pain, blurred vision, photophobia
• Nasal symptoms: chronic congestion, epistaxis
• Functional impacts: walking tolerance, fine motor tasks, work limitations
• Self-care practices and footwear use
• Medication access, adherence barriers, and beliefs about illness
• Mental health: anxiety, depression, stigma experiences, social support 

Objective data 

• Vital signs, weight trends, and signs of systemic illness
• Full skin assessment: lesion count, location, morphology, inflammation changes
• Sensory testing: monofilament or light touch, pinprick, temperature discrimination, vibration when available
• Motor testing: targeted muscle groups by nerve distribution
• Nerve palpation: enlargement, tenderness, warmth
• Hand and foot assessment: dryness, cracks, calluses, ulcers, deformities
• Wound assessment: size, depth, drainage, odor, surrounding erythema, pain perception, offloading status
• Eye assessment: lid closure, conjunctival injection, discharge, corneal appearance
• Medication adverse effects surveillance: rash, jaundice, anemia signs, cyanosis, GI intolerance
• Lab trends as ordered: CBC, liver enzymes, renal function, glucose when on corticosteroids 

Nursing diagnosis/risk for 

Common nursing diagnoses relevant to leprosy include: 

1. Risk for injury related to decreased protective sensation and motor weakness.
2. Impaired skin integrity related to neuropathy, dryness, fissures, and repeated trauma.
3. Ineffective peripheral tissue perfusion or risk for infection related to ulcers and secondary bacterial infection (use diagnosis aligned with local taxonomy and assessment).
4. Chronic pain related to neuritis and inflammatory reactions, and acute pain during reactional episodes.
5. Impaired physical mobility related to weakness, deformity, and pain.
6. Disturbed sensory perception related to peripheral nerve involvement.
7. Deficient knowledge related to disease course, transmission, medication regimen, and self-care.
8. Ineffective health management related to prolonged therapy, stigma, and access barriers.
9. Anxiety or social isolation related to diagnosis-related stigma and functional changes.
10. Risk for impaired eye integrity related to reduced corneal sensation and lagophthalmos. 

Interventions 

1) Nerve function monitoring and escalation 

• Perform and document baseline sensory and motor assessment by limb and nerve distribution at diagnosis, then at regular intervals per protocol.
• Educate patients to report immediately:
  • New nerve pain or tenderness
  • Sudden numbness increase
  • New weakness, foot drop, clawing, or loss of fine motor control
• Escalate promptly for suspected reactional neuritis, as early anti-inflammatory treatment can prevent permanent disability. 

2) Skin and wound care 

• Teach and support daily self-inspection of hands and feet using a mirror or caregiver assistance.
• Implement a moisturizing regimen to prevent fissures; avoid harsh soaps.
• For plantar ulcers:
  • Coordinate offloading strategies, protective footwear, and pressure redistribution.
  • Use wound care principles: cleansing, appropriate dressings, infection monitoring, and documentation.
  • Assess for osteomyelitis risk when ulcers are deep or chronic, and escalate for imaging and labs as ordered.
• Collaborate with podiatry and orthotics for footwear fitting and callus management. 

3) Medication management and adherence support 

• Provide clear schedules for MDT, including which medications are daily versus supervised or monthly in some programs.
• Reinforce expected benign effects (for example, rifampicin discoloration) and explain which symptoms require urgent contact (rash with fever, jaundice, severe fatigue, cyanosis).
• Monitor labs per orders and communicate abnormal results promptly.
• Assess barriers such as transportation, insurance, language, housing instability, and stigma, and involve case management and social work. 

4) Management support during reactional states 

• Assess severity: fever, nodules, lesion inflammation, nerve tenderness, weakness, eye pain.
• Provide comfort measures: rest, hydration, pain control, skin protection.
• Monitor for corticosteroid adverse effects when prescribed: glucose, BP, mood, infection signs, GI symptoms.
• Reinforce adherence to anti-inflammatory regimens and taper plans as ordered. 

5) Eye protection 

• Encourage regular eye lubrication when dryness or lagophthalmos is present.
• Teach eyelid closure assessment and nighttime protection strategies if ordered.
• Escalate urgently for red eye, pain, photophobia, or vision changes. 

6) Rehabilitation and function preservation 

• Collaborate with PT and OT for:
• Range of motion and strengthening
• Hand function exercises and adaptive devices
• Gait training and fall prevention
• Use splints and orthotics as ordered to prevent contractures and improve function.
• Encourage graded activity to support endurance and mental health. 

7) Psychosocial care and stigma reduction 

• Provide factual, calm education: leprosy is curable, and most people are not easily infected.
• Maintain confidentiality and support patient choice about disclosure.
• Screen for depression and anxiety and refer appropriately.
• Offer support resources, including community organizations and specialty clinics. 

Expected outcomes 

• Patient demonstrates correct medication adherence and completes prescribed MDT course.
• No progression of sensory or motor loss during treatment, or stabilization with timely reaction management.
• Skin lesions improve as expected, and inflammatory reactions are recognized early and treated promptly.
• Patient performs daily limb inspection and uses protective footwear or devices consistently.
• Ulcers heal or decrease in size with reduced recurrence through offloading and self-care.
• Patient verbalizes understanding of transmission and reports reduced fear and stigma-related distress.
• Eye integrity is maintained, with prompt evaluation of symptoms and prevention of corneal injury.
• Patient maintains or improves functional mobility and self-care ability with rehabilitation support. 

Individual/caregiver education 

Understanding leprosy 

• Explain that leprosy is an infection that primarily affects skin and nerves and is curable with antibiotics.
• Emphasize that casual contact does not usually spread leprosy, and prolonged exposure to untreated disease is typically required for transmission.
• Reinforce that starting appropriate therapy greatly reduces risk of transmission. 

Medication education 

• Review each medication, dose schedule, and purpose.
• Teach expected and concerning effects:
• Rifampicin may discolor urine and tears orange-red.
• Clofazimine can darken skin and cause dryness.
• Dapsone can affect blood cells; report shortness of breath, unusual fatigue, bluish lips, or rash with fever.
• Stress completion of therapy even if symptoms improve early. 

Reactional states 

• Teach warning signs that require immediate contact:
• New painful, tender nerves
• New numbness or weakness
• Sudden redness and swelling of lesions
• Fever with tender nodules or severe joint pain
• Eye pain, redness, or blurred vision 

Daily protection to prevent injury 

• Daily inspection of hands and feet, including between toes and under calluses.
• Avoid walking barefoot; use protective footwear.
• Prevent burns: test bath water temperature with an unimpaired area or a thermometer, avoid heating pads on numb areas, use gloves for cooking.
• Skin care: moisturize, treat cracks early, avoid cutting calluses at home without instruction.
• Use pacing and rest to avoid repetitive trauma. 

Wound and foot care 

• Follow wound dressing instructions and offloading plans.
• Seek care for increasing drainage, odor, surrounding redness, fever, or new swelling.
• Keep follow-up visits for wound evaluation and footwear adjustments. 

Eye care 

• Lubricate as directed, protect eyes from dust, and seek urgent evaluation for redness, pain, or vision changes. 

Caregiver support 

• Teach caregivers how to assist with daily inspection, dressing changes, and safe mobility.
• Encourage supportive communication and reduce stigma within the household.
• Provide information about contact evaluation and screening when advised by public health or specialist teams. 

Resources 

• Health Resources and Services Administration — U.S. National Hansen’s Disease Program (HRSA): https://www.hrsa.gov/hansens-disease
• ICD-10-CM resources (CMS): https://www.cms.gov/medicare/coding-billing/icd-10-codes
• ICD-10 code lookup (ICD10Data): https://www.icd10data.com/ICD10CM/Codes
• MedlinePlus health information: https://medlineplus.gov/
• World Health Organization leprosy resources: https://www.who.int/health-topics/leprosy 

References 

• Centers for Medicare and Medicaid Services (CMS). (Updated March 2026). ICD-10-CM code set resources. https://www.cms.gov/medicare/coding-billing/icd-10-codes
• Centers for Disease Control and Prevention (CDC). (December 2025). Leprosy (Hansen disease) information and clinical overview. https://www.cdc.gov/leprosy/
• Health Resources and Services Administration (HRSA). (August 2025). National Hansen’s Disease Program. https://www.hrsa.gov/hansens-disease
• ICD10Data. (n.d.). ICD-10-CM category A30, Leprosy [Hansen disease]. https://www.icd10data.com/ICD10CM/ 
• ICD10Data. (n.d.). ICD-10-CM code B92, Sequelae of leprosy. https://www.icd10data.com/ICD10CM/ 
• MedlinePlus. (n.d.). Health information resources on infectious diseases and neuropathy care. https://medlineplus.gov/