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Clinical Management of Leprosy Reactions

Graham, Anjalie RN, MPH*; Furlong, Sarah RN, MPH*; Margoles, Lindsay M. MD†; Owusu, Kwasi RN, MPH‡; Franco-Paredes, Carlos MD, MPH†§

Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e3181deba2a
Review Articles
Abstract

Leprosy reactions are an important contributor to nerve damage in patients with leprosy. Thus, it is critical to timely diagnose and effectively control them to prevent further nerve damage. Diagnosis of leprosy reactions is clinical because there are no laboratory tests or markers available for confirmation. Reactions occur among patients with borderline stages (borderline tuberculoid, borderline borderline, and borderline lepromatous) and lepromatous leprosy. Reactions may present before the initiation of multidrug therapy (MDT) with antimycobacterial drugs, during the provision of MDT, or even years after completion of MDT. Currently, corticosteroids are considered the most effective drugs for managing types 1 and 2 reactions along with continuation of MDT. Occasionally, other drugs are required in some patients to treat type 1 reactions, such as clofazimine or the use of clofazimine and/or thalidomide in patients with type 2 reactions. Long-term follow-up of patients who developed leprosy reactions is critical to prevent or ameliorate nerve damage and its sequelae.

Author Information

From the *Neil Hodgson School of Nursing, †Department of Medicine, Division of Infectious Diseases, and ‡Rollins School of Public Health, Emory University, Atlanta, GA; and §Hospital Infantil de Mexico, Federico Gomez, Mexico City, Mexico.

Reprints: Carlos Franco-Paredes, MD, MPH, Associate Professor of Medicine and Global Health, Emory University, 550 Peachtree St, Mot 7th Floor, Atlanta, GA 30308. E-mail: cfranco@sph.emory.edu.

This article was supported by the Grant Global Health Without Travel by the Emory Global Health Institute and the Healthcare Georgia Foundation.

© 2010 Lippincott Williams & Wilkins, Inc.