title: Understanding the type 1 reactional state for early diagnosis and treatment: a way to avoid disability in leprosy.
abstract: A type 1 reaction or reversal reaction is expressed clinically by inflammatory exacerbation of the skin lesions and nerve trunks, consequently leading to sensory and motor alterations. It occurs in non-polar forms of leprosy, although it can occur in a small percentage of sub-polar LL treated patients. Disabilities, deformities and morbidity, still present in leprosy, are mainly caused by these acute episodes. The recognition of reactional states is imperative for an early approach and efficient management, to avoid the emergence of disabilities that stigmatize the disease. This review aims to describe the clinical aspects, immunopathogenesis, epidemiology, histopathological features and therapeutics of type 1 reactions.
authors.affiliation: Departament of Mycobacteriosis, Leprosy Laboratory of the Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de JaneiroRJ, Brazil.
authors.forename: José Augusto da Costa
authors.initials: JA
authors.lastname: Nery
authors.forename: Fred
authors.initials: F
authors.lastname: Bernardes Filho
authors.forename: Juliana
authors.initials: J
authors.lastname: Quintanilha
authors.forename: Alice Miranda
authors.initials: AM
authors.lastname: Machado
authors.forename: Soraya de Souza Chantre
authors.initials: Sde S
authors.lastname: Oliveira
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Sales
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D042241:Early Diagnosis; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use; D056006:Leprosy, Multibacillary / Q000188:drug therapy / Q000473:pathology; D056005:Leprosy, Paucibacillary / Q000188:drug therapy / Q000473:pathology; D012307:Risk Factors; D012867:Skin / Q000473:pathology
chemical_list: D000305:Adrenal Cortex Hormones; D007917:Leprostatic Agents