title: Leprosy type 1 reaction (formerly reversal reaction).
abstract: Nerve damage leading to impairment and permanent disability is the major problem in the course of a leprosy infection. Most of the damage occurs during two types of leprosy reactions, type 1 reaction (T1R) and type 2 reaction (T2R). Timely and adequate treatment may prevent this damage. Particular T1R reactions, however, are often diagnosed too late and are even missed. Clinical symptoms and warning signs are therefore covered, as are the immunology and pathophysiology of nerve damage. The differences between upgrading and downgrading, old terms but still relevant, are explained. Methods to detect reactions and to monitor their treatment are given. Triggering factors, the mechanisms of the reactions, including autoimmunity, and the presence of physical compression are discussed. Treatment over the years is placed in its context, and based on this information a treatment schedule is recommended.
authors.affiliation: The Foundation of Global Dermatology, The Netherlands. Electronic address: benaafs@hotmail.com.
authors.forename: Bernard
authors.initials: B
authors.lastname: Naafs
authors.affiliation: Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Colette L M
authors.initials: CL
authors.lastname: van Hees
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D007918:Leprosy / Q000145:classification* / Q000150:complications / Q000175:diagnosis; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000209:etiology