Leprosy beyond MDT: study of follow-up of 100 released from treatment cases

Appearance of new skin and/or nerve lesions during or after fixed duration of multidrug therapy (MDT), in leprosy, is not uncommon. It could be a lesion due to leprosy reaction or relapse. Differentiation is easy in classical reactions both clinically and histopathologically. But, difficult in other situations especially when the relapse cases present with features of reaction at the onset. A study was done to find the reasons for released from treatment (RFT) cases to come to clinic and to follow in terms of clinical and neurological activity, leprosy reactions and deformity progression. Out of them, 14 cases and 86 cases had received paucibacillary (PB) and multibacillary (MB) multidrug therapy respectively. Skin lesions either old or new were noticed in 74% cases which might be due to inactivity or activity were noticed in 74% cases which might be due to inactivity or activity in forms of relapse and reaction. Relapse was seen in 26 cases. Out of these, 10 and 16 cases were previously diagnosed as PB and MB cases respectively. PB cases relapsed into MB cases while MB cases relapsed into MB cases. 46 cases presented with either type 1 or type 2 reaction. After declared as RFT, parasthesia in 34 cases, weakness in 18 cases, paresis and paralytic deformity in 6 cases were seen. So, all the RFT cases need regular follow-up, IEC and physiotherapy to prevent deformity and to diagnose relapse and reactions at the earliest.