MDT-MB therapy in paucibacillary leprosy: a clinicopathological assessment.
BACKGROUND
The World Health Organization recommends treatment regimens for paucibacillary (PB) and multibacillary (MB) leprosy, which differ in their duration and components. Hence accurate classification of the disease is required. To overcome difficulties in classification Uniform Multi Drug Therapy (U-MDT) has been recommended.


OBJECTIVE
To evaluate the benefit of adding clofazimine to paucibacillary regimens in leprosy patients by measuring clinical and histological resolution.


METHODS
Forty-four paucibacillary patients were included in the study. Twenty-two patients were given MDT-PB regimen and the remaining MDT-MB regimen for six months . Skin biopsies were done before the commencement and at the end of treatment. Clinical and histological resolutions were measured according to the standard criteria a laid down. The results were analyzed using Fishers' test and Crammers' V test.


RESULTS
Clinical improvement was observed in 90.9% in the MB group as compared to 27.3% in the PB group. Regression in the nerve swelling was observed in 70% in the MB group and in 37.5% in the PB group while histological resolution was observed in 72.8% and 54.5% respectively.


CONCLUSIONS
Addition of clofazimine helps to resolve leprosy lesions both clinically and histologically, thus justifying the concept of Uniform MDT regimen for all patients.
Prasad
P V S
PV
Department of Dermatology, Rajah Muthiah Medical College Hospital Annamalai University, Annamalai Nagar, Tamil Nadu, India. prasaderm@hotmail.com
Babu
A
A
Kaviarasan
P K
PK
Viswanathan
P
P
Tippoo
Rehana
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002648:Child; D002991:Clofazimine / Q000627:therapeutic use*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D017408:Guidelines as Topic; D006801:Humans; D007150:Immunohistochemistry; D007917:Leprostatic Agents / Q000627:therapeutic use*; D007918:Leprosy / Q000145:classification / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D012867:Skin / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome; D014944:World Health Organization
D007917:Leprostatic Agents; D002991:Clofazimine