The muscle functions most affected in leprosy are
eye closure (facial nerve), finger abduction (ulnar nerve), thumb opposition (median nerve), wrist extension (radial nerve), and ankle extension (common peroneal nerve
WHO-recommended multidrug therapy for multibacillary leprosy is a
monthly dose of rifampin together with
daily doses of dapsone and
daily and monthly doses of clofazimine
X 12 months
with paucibacillary leprosy are treated with
receiving monthly doses of rifampin and daily doses of dapsone
X 6 months
develops 6 weeks after the commencement of dapsone administration and manifests as fever, skin rash, eosinophilia, lymphadenopathy, hepatitis, and encephalopathy
DDS
Dapsone hypersensitivity syndrome
The most noticeable adverse event is skin discoloration ranging from red to purple or black. Urine, sputum, and sweat may become pink, also produces a characteristic ichthyosis on the shins and forearms
Clofazimine
Relapse in leprosy
multiplication of M. leprae, with an increase of at least 2+ over the previous value in the bacteriologic index at any single site
Type III hypersensitivity reaction; Evanescent, pink-to-red maculopapular, papular, nodular, or plaque lesions suddenly appear and are usually accompanied by constitutional symptoms like malaise and fever, with or without painful swelling in the joints
Type 2 Leprosy reaction (Erythema nodosum leprosum)
Delayed hypersensitivity reaction; is usually observed in the borderline portion of the spectrum. Skin lesions are characterized by acute swelling and redness. Nerves may be painful and tender because of neuritis, with consequent nerve damage and disfigurement
Type 1 Leprosy reaction
Reversal reaction
A 28-year-old man presents with multiple skin lesions evolving over 8 months. Examination reveals numerous bilateral, asymmetrical hypopigmented plaques of varying shapes and sizes involving the trunk and extremities. The lesions have ill-defined outer margins, minimal sensory loss, and some appear annular with a “punched-out” inner edge. Several peripheral nerves are mildly thickened. Slit-skin smear shows 2+ acid-fast bacilli. Lepromin skin test is negative.
Which of the following is the most likely classification of leprosy?
A. Tuberculoid (TT) leprosy
B. Borderline tuberculoid (BT) leprosy
C. Mid-borderline (BB) leprosy
D. Borderline lepromatous (BL) leprosy
E. Lepromatous (LL) leprosy
C. Mid borderline Leprosy
are multiple plaque lesions and, not infrequently, macular lesions; the lesions are of various shapes and sizes, are bilateral, and usually occur in a more or less symmetrical distribution
A 34-year-old woman presents with three hypopigmented macular lesions on the right forearm and face. The lesions are well-defined, dry, and hairless with complete loss of pain and temperature sensation. The ulnar nerve on the affected side is thickened and tender. Slit-skin smear is negative for AFB. Lepromin test is strongly positive.
What is the most likely diagnosis?
A. Indeterminate leprosy
B. Borderline tuberculoid leprosy
C. Tuberculoid leprosy
D. Mid-borderline leprosy
E. Primary neuritic leprosy
C. Tuberculoid leprosy
a well-defined, hypopigmented macule or as a raised, erythematous/brown/copper-colored plaque with a well-defined edge. The lesions may be found on any part of the skin and are characterized by complete loss of fine touch and temperature sensations over their surface
A 40-year-old man with known borderline leprosy develops acute erythema and swelling of existing skin lesions, accompanied by neuritis and worsening sensory loss shortly after starting multidrug therapy. Slit-skin smear remains unchanged.
This reaction is best described as:
A. Type 2 lepra reaction
B. Lucio phenomenon
C. Type 1 lepra reaction (reversal reaction)
D. Drug hypersensitivity reaction
E. Immune reconstitution inflammatory syndrome
C. T1R
T2R- Evanescent, pink-to-red maculopapular, papular, nodular, or plaque lesions suddenly appear and are usually accompanied by constitutional symptoms like malaise and fever, with or without painful swelling in the joints. They are painful or tender and warm, blanch with light finger pressure, and last for a few days. The lesions change in color from pink/ red to bluish and brownish after 24–48 h and turn dark in a week
Identify:
Marked vasculitis and thrombosis of the superficial and deep vessels result in hemorrhage and infarction of the skin. Clinically, the skin reaction begins as slightly indurated, bluish-red, ill-defined, painful, and rarely palpable plaques with an erythematous halo, usually developing on one limb but sometimes on other areas of the body
Lucio’s phenomenon
