Type 2 leprosy reaction presenting as a monoarthritis post multidrug therapy

Introduction: During the course of leprosy, 10 to 50% of individuals can be surprised by reaction states, which are immune system reactions of the patient to Mycobacterium leprae. Leprosy reactions constitute the main cause of nerve damage and disability caused by leprosy. Objective:To analyze the clinical and therapeutic profile of patients with leprosy reactions registered in a Dermatology Service in the city of Belém-PA. Methods:This is a cross-seccional, descriptive study. It was investigated through analysis of medical records, 52 patients who fit the established inclusion criteria. Data were collected in july and august 2016. Results: It was found a predominance of men, from the metropolitan region. The clinical form most common of Leprosy was Borderline, and the leprosy reaction type 1. The most of reactions occurred right after the introduction of multidrug therapy,and more than a half of patients with type 1 reaction showed edema of limbs. Regarding the type 2, fever and general symptoms were the most common, present in all cases. The frequency of neural damage was evident, showing reduction of motor force level andloss of protective sensation. Conclusion: Early diagnosis and appropriate therapeutic management of reactive events is critical to the prevention of disabilities.

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Lucio's phenomenon: another case reported in Brazil

Anais Brasileiros de Dermatologia ◽

10.1590/s0365-05962012000200017 ◽

2012 ◽

Vol 87 (2) ◽

pp. 296-300 ◽

Cited By ~ 10

Author(s):

Rodrigo Monteiro ◽

Marcelo Guimarães Tiezzi ◽

Marilda Aparecida Milanez Morgado de Abreu ◽

Claudia Cardoso Macedo de Oliveira ◽

Eduardo Vinícios Mendes Roncada ◽

...

Keyword(s):

Rare Event ◽

Lepromatous Leprosy ◽

Coagulation System ◽

Multidrug Therapy ◽

Tissue Necrosis ◽

Inflammatory Reactions ◽

Vascular Lumen ◽

Endothelial Proliferation ◽

Lucio’S Phenomenon

Lucio's phenomenon is defined as a variant of type 2 leprosy reaction. It is a rare event, occurring in the evolution of leprosy of Lucio and other forms of lepromatous leprosy. It has an exacerbated proliferation of Hansen bacilli in its pathophysiology, which invade blood vessel walls and injure endothelial cells, causing endothelial proliferation and decreasing the vascular lumen. This fact, associated with inflammatory reactions and changes in the coagulation system causes vascular thrombosis, ischemia, infarction and tissue necrosis, leading to the histopathological characteristic of the phenomenon. We report a case of lepromatous leprosy with irregular treatment that developed Lucio's phenomenon. Treatment with multidrug therapy, antibiotics, steroids and thalidomide achieved a favorable outcome.

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Cutaneous ulceration as a presenting feature of type 1 lepra reaction: A case report

Tropical Doctor ◽

10.1177/00494755211068661 ◽

2022 ◽

pp. 004947552110686

Author(s):

Pallavi Hegde ◽

Deepti Jaiswal ◽

Varsha M Shetty ◽

Kanthilatha Pai ◽

Raghavendra Rao

Keyword(s):

Case Report ◽

Erythema Nodosum ◽

Immunological Response ◽

Lepromatous Leprosy ◽

Multidrug Therapy ◽

Cutaneous Lesions ◽

Erythema Nodosum Leprosum

Reactions in leprosy represent sudden shift in the immunological response and are seen in 11–25% of affected patients. It can be seen before, during or after the completion of multidrug therapy (MDT). 1 Two types of reactions are recognized; Type 1 reaction (T1R), seen in borderline leprosy, affecting mainly skin and nerves; type 2 reaction (T2R) or erythema nodosum leprosum (ENL), seen in lepromatous leprosy, characterized by systemic features in addition to cutaneous lesions. Trophic ulcers and ulcerating ENL are well known entities while cutaneous ulceration in T1R is extremely rare; we describe an immune-competent woman with cutaneous ulceration as a presenting feature to highlight the need to recognize this entity at the earliest opportunity.

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Epidemiology of Leprosy in Childhood: A Retrospective Study

BioScientia Medicina ◽

10.32539/bsm.v5i5.309 ◽

2021 ◽

Vol 5 (5) ◽

pp. 484-492

Author(s):

Rusmawardiana ◽

Fifa Argentina ◽

Indri Widya Sari

Keyword(s):

Retrospective Study ◽

Pediatric Patients ◽

World Health ◽

Age Group ◽

Who Guidelines ◽

Multidrug Therapy ◽

Duration Of Illness ◽

History Of ◽

Health Organization

Background: Children are the group most susceptible to Mycobacterium leprae infection. The proportion of new leprosy cases in children is indicator of successful leprosy elimination program from World Health Organization (WHO), so this study would like to know the epidemiology of pediatric leprosy at Dermatology and Venereology Polyclinic, Dr. Mohammad Hoesin Palembang. Methods: Retrospective study of all new cases of leprosy in children (0-17 years) who came to Dermatology and Venereology Polyclinic, Dr. Mohammad Hoesin Palembang from January 2017 to December 2020. Results: There were 10 pediatric patients (7.58%) from 132 new leprosy cases. Most cases (40%) were in the 15-17 age group. There are more male than female. Most types of leprosy are BL (60%) followed by TT (20%). Manifestations of hyperpigmented skin patches and nervous disorders, grade 1 disability, and type 2 leprosy reactions are mostly found in type BL leprosy. The duration of illness 6-12 months has a grade 1 disability (30%). The history of positive contact came from same household in 3 cases (30%) with 7 people (70%) domiciled in Palembang. All cases received Multidrug Therapy (MDT) treatment according to WHO guidelines. Conclusion: Found 10 new cases of leprosy in children in Dermatology and Venereology Polyclinic Dr. Moh. Hoesin Palembang for four years, especially in the 15-17 age group, with the most cases being type BL leprosy. Household contact still plays an important role in leprosy transmission.

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Epidemiology of Leprosy in Childhood: A Retrospective Study

BioScientia Medicina ◽

10.32539/bsm.v5i3.309 ◽

2021 ◽

Vol 5 (3) ◽

pp. 508-516

Author(s):

Rusmawardiana Rusmawardiana ◽

Fifa Argentina ◽

Indri Widya Sari

Keyword(s):

Pediatric Patients ◽

Household Contact ◽

World Health ◽

Age Group ◽

Who Guidelines ◽

Multidrug Therapy ◽

Duration Of Illness ◽

History Of ◽

Health Organization

A B S T R A C TBackground: Children are the group most susceptible to Mycobacterium lepraeinfection. The proportion of new leprosy cases in children is indicator of successfulleprosy elimination program from World Health Organization (WHO), so this studywould like to know the epidemiology of pediatric leprosy at Dermatology andVenereology Polyclinic, Dr. Mohammad Hoesin Palembang. Methods:Retrospective study of all new cases of leprosy in children (0-17 years) who cameto Dermatology and Venereology Polyclinic, Dr. Mohammad Hoesin Palembangfrom January 2017 to December 2020. Results: There were 10 pediatric patients(7.58%) from 132 new leprosy cases. Most cases (40%) were in the 15-17 agegroup. There are more male than female. Most types of leprosy are BL (60%)followed by TT (20%). Manifestations of hyperpigmented skin patches and nervousdisorders, grade 1 disability, and type 2 leprosy reactions are mostly found in typeBL leprosy. The duration of illness 6-12 months has a grade 1 disability (30%).The history of positive contact came from same household in 3 cases (30%) with7 people (70%) domiciled in Palembang. All cases received Multidrug Therapy(MDT) treatment according to WHO guidelines. Conclusion: Found 10 new casesof leprosy in children in Dermatology and Venereology Polyclinic Dr. Moh. HoesinPalembang for four years, especially in the 15-17 age group, with the most casesbeing type BL leprosy. Household contact still plays an important role in leprosytransmission.

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Infections and reactions in leprosy: a diagnostic dilemma

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20180147 ◽

2018 ◽

Vol 4 (1) ◽

pp. 96

Author(s):

Jasleen Kaur ◽

Jyotika Kalsy ◽

Riya Kaur Kalra

Keyword(s):

Public Health ◽

Infectious Disease ◽

Public Health Problem ◽

Mycobacterium Leprae ◽

Multidrug Therapy ◽

Case Patient ◽

Diagnostic Dilemma ◽

The World ◽

Leprosy Patients

<p>Leprosy (Hansen’s disease) is a chronic infectious disease caused by <em>Mycobacterium leprae</em>. It continues to be a public health problem in India, which contributes about 60% to the world leprosy burden. Leprosy patients when on treatment can develop either lepra reactions or reactions due to antileprosy drugs, also they can develop other infections endemic in their areas during the course of their disease. We are presenting such two cases where in one case patient on treatment with multibacillary multidrug therapy (MBMDT) developed fever, lympadenopathy and other systemic features during the course of therapy and was mistakenly diagnosed as type 2 lepra reaction but turned out to be a case of dapsone hypersensitivity. Similarly another case developed fever and other systemic features after 6 weeks of MBMDT, thinking it to dapsone syndrome his MBMDT pack was stopped but later it turned out to be a case of dengue.</p>

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