Reactions and their management.
The uneventful response to chemotherapy in leprosy is marked by clinically disturbing episodes encountered in 20-30% of patients and these phenomena are called "reactions". Generally they are classified as reversal reaction (type-1) and erythema nodosum leprosum (type-2). The cutaneous menifestations are: (1) Type-2 reactions in LL, BL types constituting erythema nodosum leprosum, erythema multiforme, erythema necroticans, subcutaneous nodules, lepromatous exacerbation. (2) Type-1 reactions in borderline and tuberculoid leprosy. The other manifestations include: Acute neuritis, lymphadenitis, arthritis, oedema of the hands and feet, ocular lesions, etc. Sequelae of reactions are: Paralytic deformities, non-paralytic deformities, extensive scarring and renal damage. A simple guideline to identify the risk-prone cases has been narrated. Prednisolone in standard dosage schedule as recommended by WHO is now being widely used in control programmes.
Ganapati
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Bombay Leprosy Project, Mumbai 400022.
Pai
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D001168:Arthritis / Q000139:chemically induced; D002921:Cicatrix / Q000139:chemically induced; D002991:Clofazimine / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D064420:Drug-Related Side Effects and Adverse Reactions; D004487:Edema / Q000139:chemically induced; D004890:Erythema / Q000139:chemically induced; D004893:Erythema Nodosum / Q000139:chemically induced; D005528:Foot / Q000473:pathology; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006225:Hand / Q000473:pathology; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology* / Q000276:immunology; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007918:Leprosy / Q000188:drug therapy* / Q000276:immunology*; D008199:Lymphadenitis / Q000139:chemically induced; D009443:Neuritis / Q000139:chemically induced; D010243:Paralysis / Q000139:chemically induced; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D012867:Skin / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D013792:Thalidomide / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D013792:Thalidomide; D011239:Prednisolone; D002991:Clofazimine