1 . Hands. The upper picture taken in a rural village illustrates
(a) 'claw' hands on both sides, especially the left, due to nerve damage, muscle weakness and contractures, and
(b) burns and scarring of the fingers on both sides due to loss of sensation. The patient presented late. On first diagnosis, she had obvious involvement of the median and ulnar nerves on both sides. Chemotherapy arrested the progress of her bacterial infection, but did little or nothing for the established disabilities.
The lower picture shows complete 'wrist drop' due to damage to the radial nerve in the upper arm in a young boy with active MB leprosy.
