Type 1 leprosy reversal reaction treated with topical tacrolimus along with systemic corticosteroids.
An 11-year-old black Haitian boy presented with borderline lepromatous leprosy and was treated with rifampicin, dapsone, and clofazimine. After 4 months he developed a severe type 1 reversal reaction without nerve involvement. He was started on prednisolone (1 mg/kg daily). After 4 weeks of treatment with corticosteroids, his condition did not improve and the lesions remained painful. The patient was given a therapeutic trial with twice daily application of topical tacrolimus 0.1% ointment. The result was a dramatic improvement in the skin lesions. The patient's condition was maintained by topical tacrolimus therapy, with healing of all skin lesions. The prednisolone dose was then tapered to zero over a period of 12 weeks. To the best of our knowledge, this is the first report of the efficacy of topical tacrolimus in the treatment of type 1 leprosy reaction.
Safa
Gilles
G
Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, France. gilles.safa@ch-stbrieuc.fr
Darrieux
Laure
L
Coic
Alain
A
Tisseau
Laurent
L
D000287:Administration, Topical; D002648:Child; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006205:Haiti; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015439:Leprosy, Borderline / Q000188:drug therapy*; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use*
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011239:Prednisolone; D016559:Tacrolimus