Persistent reaction in paucibacillary leprosy: case reports.
Three patients of histopathologically confirmed borderline-tuberculoid leprosy showing no acid-fast bacilli and with lesions confined to the face, 2 on the cheek and 1 on the forehead, were given multidrug therapy as recommended by the WHO for paucibacillary cases. Within 3 months the lesions showed signs of upgrading (or reversal) reaction which was substantiated by histopathology. In 1 patient the facial nerve was affected leading to facial palsy. The lymphocyte transformation test did not show a significant rise. All 3 patients were given oral prednisolone for periods varying between 5 and 7 months, but the response was poor except in 1 patient in whom the facial palsy responded favourably. Injections of sodium antimony gluconate tried in 1 patient after stoppage of steroids did not control the reaction. After 18 months of regular follow-up during therapy, the cutaneous reaction in the patient with facial nerve involvement subsided leaving significant atrophy. However, in the other 2 patients the skin lesion persisted with clinical and histopathological evidence of upgrading reaction. The reasons for the unnatural persistence of reaction in these patients is not clear.
Saxena
U
U
Institute of Pathology (ICMR), New Delhi.
Ramesh
V
V
Misra
R S
RS
Mukherjee
A
A
D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015439:Leprosy, Borderline / Q000188:drug therapy / Q000473:pathology*; D015441:Leprosy, Tuberculoid / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology*; D013997:Time Factors
D000893:Anti-Inflammatory Agents