Diagnosis and treatment of leprosy type 1 (reversal) reaction.
Leprosy is a chronic granulomatous infection caused by the organism Mycobacterium leprae that primarily affects the skin and peripheral nerves. Leprosy has several distinct clinical presentations ranging from moderate to severe, with the extent of disease generally depending on the host's immune response to the infection. Treatment typically involves antimicrobials (eg, clofazimine, dapsone, rifampin). Once treatment is started, an important aspect of patient care is the recognition of possible reversal reactions. We report the case of a 44-year-old man who repeatedly developed physical findings consistent with a type 1 (reversal) reaction after undergoing multiple treatments for leprosy. A discussion of leprosy along with its clinical manifestations, treatment methods, and management of reversal reactions also is provided.
Johns Hopkins Hospital, Department of Dermatology, 1500 Orleans St, Baltimore, MD 21231, USA.
Sarah M
SM
Sung
Todd T
TT
Kobayashi
D000328:Adult; D000942:Antigens, Bacterial / Q000276:immunology; D003937:Diagnosis, Differential; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*; D007917:Leprostatic Agents / Q000627:therapeutic use; D015440:Leprosy, Lepromatous / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D009166:Mycobacterium leprae / Q000276:immunology; D012008:Recurrence; D012867:Skin / Q000473:pathology*
D000942:Antigens, Bacterial; D007917:Leprostatic Agents