The diagnosis of leprosy should in most cases permit a prognosis to be made as well. This offers three important advantages to the physician: It enables him to decide on the disposition of the case, whether to isolate or merely observe; it permits him to evaluate the effect (if any) of treatment; and it permits him (if it is favorable) to soften the blow when he informs the patient of the diagnosis.
These advantages can be accomplished only by making an exact diagnosis: that is, not merely "leprosy," but "leprosy, lepromatous," or "leprosy, `neural'." Lepromatous leprosy has a bad prognosis for arrest or recovery; "neural" leprosy has a good prognosis for arrest or recovery. It is rare for the disease to undergo transition from either type to the other, and it is probably impossible for a patient to present both types simultaneously. The term "mixed leprosy"
Arnold HL. DIFFERENTIATION OF LEPROMATOUS FROM "NEURAL" LEPROSY: THE BASIS, A METHOD, AND REPORT OF FIVE CASES. Arch Derm Syphilol. 1945;52(5):354–364. doi:https://doi.org/10.1001/archderm.1945.01510290059011
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