Successful plasma exchange in type 1 leprosy reversal reaction

A 24 year old man admitted to hospital with borderline lepromatous leprosy was treated with rifampicin, dapsone, and clofazimine. After four months he developed a reversal reaction and the diagnosis was modified to borderline tuberculoid leprosy. The dose of clofazimine was raised and prednisolone added to the regimen without any symptomatic response. His condition improved dramatically after five plasma exchanges on five successive days.