<\/span><\/h2>\nLeprosy is a bacterial<\/span> infectious disease that mainly affects people in developing countries, including Brazil, Bangladesh, India, the Democratic Republic of the Congo and Nigeria.<\/p>\n\n- In these regions, the annual incidence<\/span> The leprosy rate is around one in 100 000 inhabitants, which is less than necessary to consider it endemic<\/span> disease.<\/li>\n
- Leprosy is caused by Mycobacterium leprae<\/em>, which grows very slowly and is generally transmitted by air.<\/li>\n
- The classic clinical pattern of leprosy involves the skin, nerves<\/span>and nasal and oropharyngeal<\/span> mucous membrane<\/span>. Leprosy can lead to significant disability and stigmatization. <\/li>\n
- Curative treatment for the undetermined stage of leprosy includes rifampin and dapsone; Clofazimine is added to the multibacillary leprosy form (which has numerous bacilli).<\/li>\n
- A immune <\/span>the disorder can occur during the course of the disease; This is called a leprosy reaction.<\/li>\n
- Reactions to leprosy occur mainly after treatment for leprosy is started, but can also occur without treatment.<\/li>\n<\/ul>\n
<\/span>Type 1 leprosy reaction<\/span><\/h2>\n<\/span>What is a type 1 leprosy reaction?<\/span><\/h3>\nType 1 leprosy reaction is a type of delay hypersensitivity<\/span> to M. leprae<\/em> antigens<\/span>. Also called leprosy reaction 1.<\/p>\n\n- The type 1 leprosy reaction occurs more frequently after treatment for leprosy has started, but it can also occur before and after treatment.<\/li>\n
- Reflects a strengthening of specificity cellular<\/span> immunity against M. leprae<\/em> towards the tuberculoid type.<\/li>\n<\/ul>\n\n
<\/span>Type 1 leprosy reactions in borderline tuberculoid leprosy<\/span><\/h5>\n<\/section>\n\n\n
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Borderline tuberculoid leprosy with type 1 reaction<\/p>\n
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Courtesy<\/p>\n<\/p><\/div>\n<\/section>\n
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<\/span>Who has the type 1 leprosy reaction?<\/span><\/h3>\nThe leprosy 1 reaction is unpredictable. It occurs in patients with borderline disease; that is, the transition between tuberculoid leprosy and lepromatous leprosy. <\/p>\n
The classification of limit leprosy includes:<\/p>\n
\n- Borderline tuberculoid leprosy<\/li>\n
- Borderline borderline leprosy<\/li>\n
- Lepromatous leprosy limit.<\/li>\n<\/ul>\n
<\/span>What are the clinical characteristics of the type 1 leprosy reaction?<\/span><\/h3>\nType 1 leprosy reactions generally affect the skin and nerves, and there is no systemic<\/span> Symptoms The reaction is classified as mild or severe.<\/p>\nThe cutaneous signs of the type 1 leprosy reaction include:<\/p>\n
\n- \nErythema<\/span> and hardening<\/span> of existing injuries<\/li>\n
- \nUlceration<\/span> during very intense reactions<\/li>\n<\/ul>\n
Nervous participation in the reaction of leprosy type 1 and:<\/p>\n
\n- It mainly affects elbow<\/span>external sciatic popliteal<\/span>, facial and cervical nerves<\/li>\n
- It often produces pain or tenderness.<\/li>\n
- It can cause loss of function for more than a few days, it can cause muscle weakness, loss of sensation, paralysis<\/span>or deformity.<\/li>\n<\/ul>\n
A mild type 1 leprosy reaction is characterized by a few swollen plates<\/span> and without nerve damage. A severe type 1 leprosy reaction is characterized by many inflamed plaques and nerve damage.<\/p>\n<\/span>How is a type 1 leprosy reaction diagnosed?<\/span><\/h3>\nA type 1 leprosy reaction is clinically suspected in a patient with borderline leprosy who develops symptoms within a few months of starting treatment. <\/p>\n
There are no routine laboratory tests. A skin biopsy<\/span> can reveal:<\/p>\n\n- Granulomas<\/span><\/li>\n
- \nMultinucleate<\/span> giant cells<\/span>\n<\/li>\n
- \nEdema<\/span>.<\/li>\n<\/ul>\n
No increase in polymorphonuclear<\/span> neutrophils<\/span><\/span> in the patient's blood count or a change in C-reactive protein<\/span> (CRP<\/span>) levels. Type 1 leprosy reactions have been associated with elevated levels of serum<\/span> chemokine<\/span> 10)<\/p>\n<\/span>What is the treatment for a type 1 leprosy reaction?<\/span><\/h3>\nA mild leprosy 1 reaction requires supportive care. This involves:<\/p>\n
\n- Current<\/span> steroids<\/li>\n
- Analgesics<\/li>\n
- Supervision.<\/li>\n<\/ul>\n
A severe type 1 leprosy reaction with nerve failure requires immediate treatment.<\/p>\n
\n- The first-line treatment is prednisone or prednisolone 0.5\u20131 mg \/ kg \/ day until inflammation<\/span> It has been reduced, followed by a slow dose decrease.<\/li>\n
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Cyclosporine is a second-line treatment for severe type 1 reactions not controlled by prednisone.<\/li>\n
- Neurolysis or nerve surgery to relieve pressure may be necessary if deterioration of the nerve persists.<\/li>\n
- Treatment with rifampin, dapsone, and \/ or clofazimine should continue.<\/li>\n<\/ul>\n
<\/span>What is the result of a type 1 leprosy reaction?<\/span><\/h3>\nThe natural course of an untreated type 1 leprosy reaction is for it to persist for several months.<\/p>\n
\n- Skin lesions continue to swell and may become confluent<\/span>.<\/li>\n
- Nerve disturbance can be very serious, leading to loss of function and disability.<\/li>\n<\/ul>\n
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<\/span>Type 2 leprosy reaction<\/span><\/h2>\n<\/span>What is a type 2 leprosy reaction?<\/span><\/h3>\nA type 2 leprosy reaction is characterized by a acute<\/span> immune complex vasculitis<\/span> affecting the skin and other organs. It is poorly understood. Also called leprosy 2 reaction or erythema nodosum leprosum.<\/p>\n\n<\/span>Type 2 leprosy reactions<\/span><\/h5>\n<\/section>\n\n\n
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Leprosy erythema nodosum<\/p>\n
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Leprosy erythema nodosum<\/p>\n
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Courtesy of Professor Jayamini Seneviratne<\/p>\n
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Leprosy type 2 reaction<\/p>\n
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Leprosy type 2 reaction<\/p>\n
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Leprosy type 2 reaction<\/p>\n<\/p><\/div>\n<\/section>\n
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<\/span>Who has the type 2 leprosy reaction?<\/span><\/h3>\nThe type 2 leprosy reaction occurs in patients with:<\/p>\n