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*respiratory transmission? difficult to determine because of long incubation period
*skin + peripheral nerve manifestation
**''M. leprae'' has affinity to Schwann cells and destroy them
*clinical manifestation differs in wide range depending on amount of bacilli and host immune response
*WHO classification
**BL
**LL
*delay of Dx and Tx leads to long term disability and deformity resulted in stigma and discrimination
==Buruli ulcer==
*''Mycobacterium ulcerans''
*75% of worldwide patients are in Ivory Coast, Ghana and Benin
**rarely found in Japan and Australia (esp. in Victoria)
*transmission route unknown
**patients are often in proximity of stagnant water body
*undermined wound edges, thick necrotic tissue, pain is liminited
*3 months course
#subcutaneous nodules
#plaque
#edema - develops pain
#ulcer
*lipid toxin produced and secreted by ''M. ulcerans'' is pathogenetic
**highly hydrophobic
**''M. ulcerans'' itself is not pathogenetic
