These are visible in the final stages of the disease. In these end stages, it is also possible to see some facial changes - like flattening of the nose, swollen face and yellowish discolourisation of the skin. People fear these deformities and hence, they dread leprosy. So, any hypo pigmented patch, any skin rash that is non itchy, that does not cause any trouble to the patient, should be investigated. Any loss of sensation in the fingers, in wounds, or any shooting pain noticed in the hands and feet should be brought to the notice of the doctor.
Diagnosis is basically, by clinical examination.
If there is any typical skin lesion that has a loss of sensation, that is dry and where there is loss of hair, and has if the lesion has been persistent for quiet sometime, then, it has to be checked. There are certain tests or investigations that are done that can provide corroboratory evidence or confirm the diagnosis. One of them is a smear test. In this, we make a small cut with a knife. A small cut is made in the skin and the fluid is collected.