The Ridley-Jopling classification places leprosy patients into a spectrum with polar tuberculoid (TT) and lepromatous (LL) and middle types of borderline tuberculoid (BT), mid-borderline (BB) and borderline lepromatous (BL) leprosy. These have been categorised, for treatment purposes, into paucibacillary (PB) and multibacillary (MB) depending on lesion counts and the results of skin smear examinations. Lepromatous leprosy (LL) presents at onset usually with symmetrically distributed nodules, plaques or hypopigmented macules on the trunk. If LL progresses, skin begins to thicken predominantly in the forehead, earlobes, eyebrows and cheeks, which eventually leads to the classic leonine facies.
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