Leprosy Stigma

Abstract

Stigma has been defined by Goffmanl as an attribute that is deeply discrediting, and the stigmatized individual is one who is not accepted and not accorded the respect and regard of his peers; one who is disqualified from fu \1 social acceptances. Goffman uses the term 'd iscreditable individual' for the person who assumes his differentness is neither known about by those present nor immediately perceivable by them, and he goes on to describe three main groups of stigmatized individuals. Firstly, those with physical deformities, particularly of the face. Additional examples are scars on the wrists of those who have attempted suicide, and the injection marks on the arms of drug addicts. Secondly, those with blemishes of character, inferred by a history of mental disorder, epilepsy, imprisonment, drug addiction, alcoholism, homosexuality, unemployment, suicidal attempt, and radical political behaviour. Thirdly, those with tribal stigma of race, nation, social class, and religion. Leprosy stigma Applying Goffman's definitions to leprosy, we can see that a\1 of his three groups of stigmatized individuals are encompassed by the one disease: in the group with physical deformities we have the face of the neglected lepromatous patient, the facial plaque of the nonlepromatous patient (especially if in reaction), facial palsy, claw hand deformity or fo otdrop (both of which may identify the leprosy sufferer in an endemic country), or the hypopigmented macules which are so conspicuous on a dark skin. In the group with blemished character we have segregation in a leprosarium, or a history of such segregation. For Christian and Je wish communities we can add the use of the word 'l eprosy' in the Bible as a punishment for sin. In the group with tribal stigma we have the immigrant worker in, say, a country of Western Europe, who has been fo und to have leprosy; not only is he a fo reigner but he is likely to have a pigmented skin and to belong to the working class, factors which render him 'i nferior'. He may even not be a Christian. The 'tribal' factor in countries where leprosy is endemic is poverty, for society looks upon leprosy as a disease of poverty.

Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination

“…In addition to physical impairments and activity restrictions, PLD are likely to suffer from social stigma and discrimination leading to economic loss (9). According to the ICF, social stigma and discrimination is considered an important ‘environmental factor’ that contributes to disability (3, 10, 11).…”

Fine Needle Aspiration Cytology of Reactions in Leprosy

“…Type 2 reactions, occurring in lepromatous leprosy -lepromatous leprosy (LL) and borderline lepromatous-are manifestations of immune complex phenomena of the Arthus type. Reactions, acute episodes in the otherwise indolent course of leprosy, 7 are responsible for much of the symptoms that occur, including virtually all symptoms that arise acutely. These may be so acute that they compel the patient to seek medical attention, often for the first time.…”

Psoriatic arthritis in a fifth-century Judean Desert monastery

“…While skin sensation and rhinomaxillary involvement clearly delineates the two diseases, the effects on the limbs must have presented diagnostic problems in the past. Even today, according to Cochrane (1964) and Jopling (1986), two of the worlds most respected leprologists, diagnosing leprosy is difficult for the trained dermatologist who is unfamiliar with the bewildering variety of cutaneous manifestations of the disease. Because of these diagnostic difficulties, the number of diseases that has been mistakenly diagnosed under the umbrella term of leprosy in early times is legion (Cochrane, 1964).…”