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How is it Diagnosed?
Based on presence of any one of the following Cardinal signs.

Sr. No Cardinal Signs of Leprosy Method of Eliciting
1 Hypopigmented or reddish 
Skin lesion(s) with definite loss of sensation
Anaesthesia on the patch to be elicited by testing for touch, pain and temp. sensation
2 Thickening of peripheral nerves with loss of sensation and weakness of the muscles of the hands, feet or face Examination of peripheral nerves e.g 1) Greater Auricular 2) Radial 3) Ulnar 4) Median 5) Lateral Popliteal 6) Posterior Tibial etc.
3 Demonstration of Mycobacterium Leprae (M.leprae) in the lesions Acid fast staining and examination Under oil immersion microscope
The first two cardinal signs can be identified by clinical examination alone while the third by examination of the slit skin smear under the microscope. Bacteriological examination has been discontinued in the programme.

Pre–requisites of Good Clinical Examination Clinical Examination of Leprosy Field classification of leprosy for purpose of MDT

Clinical Manifestation PB (Pauci–Bacilli) MB (Multi Bacillary)
Skin Lesion Upto 5 lesion 6 and above
Nerve involvement No nerve involvement or only one nerve involvement more than one nerve trunk involvement