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[Relapses after multibacillary leprosy treatment]
Gerzaín Rodríguez1, Rafael Pinto, Carlos Laverde
1Laboratorio de Patología, Instituto Nacional de Salud, Bogotá, DC, Colombia. grodriguez@ins.gov.co
Biomedica : Revista Del Instituto Nacional De Salud
|October 22, 2004
Summary
Leprosy relapses are often caused by persistent bacteria and diamino-diphenyl-sulphone (DDS) monotherapy. Regular, supervised treatment is crucial for preventing relapses in multibacillary leprosy patients.
Area of Science:
- Infectious Diseases
- Dermatology
- Microbiology
Context:
- Leprosy, particularly lepromatous leprosy (LL), poses a significant risk of relapse.
- Diamino-diphenyl-sulphone (DDS) monotherapy has been historically linked to treatment failures and bacillary persistence.
- Irregular or unsupervised polychemotherapy (PCT) may also contribute to relapse.
Purpose:
- To investigate the causes and predisposing factors of leprosy relapses in patients treated with DDS monotherapy and polychemotherapy.
- To evaluate diagnostic methods for leprosy relapse, including clinical signs, bacilloscopy, and skin biopsy.
Summary:
- This study analyzed 33 lepromatous leprosy patients experiencing relapses after DDS monotherapy or irregular PCT.
- Predisposing factors included DDS monotherapy, inadequate/unsupervised PCT, non-compliance, and poor patient-staff relations.
- Relapses were diagnosed clinically and confirmed by bacilloscopy and skin biopsy, with some showing indeterminate or borderline tuberculoid forms.
Impact:
- Highlights the inadequacy of DDS monotherapy and irregular PCT in preventing leprosy relapses.
- Recommends regular inspections for relapse in all multibacillary patients previously treated with DDS.
- Emphasizes the combined effectiveness of clinical examination, bacilloscopy, and skin biopsy for accurate relapse diagnosis.