Gynaecomastia in leprosy in three districts of Tamil Nadu

The prevalence of Gynaecomastia (GM), a well known complication of leprosy in adult male patients was studied in 790 cases of whom 641 were the inmates of five leprosy hospitals and the remaining 149 mostly from the clinics of field area attached to the Central Leprosy Teaching and Research Institute, Chengalpattu during 1982-83. The overall prevalence rate was found to be 19.24%. Among the hospitalised patients, it was 22.15% against 6.71% among the patients attending the clinics in the field area. The youngest and the oldest patient in this study was 16 years and 83 years respectively. The highest rate of 32.89% was in the 36-45 age group. Only 152 GM cases were detected; the rates in the lepromatous, borderline lepromatous, borderline tuberculoid were 29.21%, 9.64% and 3.68% respectively. Those who gave a history of frequent ENL reactions had a higher rate of GM i.e. 34.55 as against 21.52 without or with very infrequent ENL reaction. Early treatment had a remarkable effect in the reduction of GM. Only 14% developed GM when the treatment was started within 2 years after the onset of leprosy as against 46.9% when the same was started after 16 years. In the latter group, the longer duration of the disease could also play a contributory role. Sterility rate was more than double in those with GM i.e. 34.14% against 14% without it.