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Persistent reaction in paucibacillary leprosy: case reports.

U Saxena1, V Ramesh, R S Misra

  • 1Institute of Pathology (ICMR), New Delhi.

Leprosy Review
|June 1, 1991
PubMed
Summary
This summary is machine-generated.

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Multidrug therapy for borderline-tuberculoid leprosy can trigger reactions, even with no acid-fast bacilli. Treatment with steroids and other agents showed poor response in most patients, indicating unclear reasons for persistent reactions.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Immunology

Background:

  • Leprosy, specifically borderline-tuberculoid leprosy, presents diagnostic challenges.
  • Paucibacillary leprosy cases are typically treated with WHO-recommended multidrug therapy (MDT).
  • Facial nerve involvement and reversal reactions can complicate leprosy management.

Observation:

  • Three patients with histopathologically confirmed borderline-tuberculoid leprosy and facial lesions received MDT.
  • Within three months, patients exhibited histopathologically confirmed upgrading (reversal) reactions.
  • One patient developed facial palsy, and lymphocyte transformation tests showed no significant response.

Findings:

  • Standard MDT for paucibacillary leprosy induced reversal reactions in all three patients.

Related Experiment Videos

  • Corticosteroids and sodium antimony gluconate showed limited efficacy in managing these persistent reactions.
  • While one patient's facial palsy improved, skin lesions persisted in two patients, suggesting an atypical disease course.

    • Implications:

    • The study highlights the potential for unpredictable reactions to MDT in borderline leprosy.
    • Current treatment protocols may require adjustments for managing persistent reversal reactions.
    • Further research is needed to elucidate the mechanisms behind the prolonged reactions and optimize therapeutic strategies.