2. • DIAGNOSIS AND TREATMENT OF
LEPROSY:
Usually Confirmed by a Medical Officer.
Patient presents with hypo-pigmented skin patches
with sensory loss/thickened nerve who did not recieve
any Anti-Leprosy treatment in the past.
4. TREATMENT
Treatment is usually in the form of Multi Drug Therapy (MDT) consisting of a
combination of 2 or 3 drugs in variable concentration:
RIFAMPICIN (Capsule)
DAPSONE (Tablet)
CLOFAZIMINE (Capsule)
Other drugs:
ETHIONAMIDE
QUINOLONES
MINOCYCLINE
CLARITHROMYCIN
5. Administration of MDT (AN OVERVIEW):
MDT kills the bacilli and thus stops progression, preventing
disabilities.
As the bacilli are killed, patient becomes non-infectious.
Spread of infection to other persons is also reduced.
Use of combination of 2 or 3 drugs instead of one drug will
ensure effectiveness of drug and decrease chances of
development of resistance.
In children, the doses can be adjusted suitably.
When the Patient has completed the required number of doses
of MDT regimen, they are released from the treatment.
7. LEPRA REACTIONS:
Lepra Reactions are acute inflammatory response Occuring before/during/after
treatment. Characterestic features are:
Multiple lesions
Lesions close to peripheral nerves
Lesions on face
There are principally 2 Lepra reactions:
Type 1 (Reversal reaction): Occurs in both PB and MB
Type 2 (Erythema Nodosum Leprosum): Only in MB leprosy
8.
9. MANAGEMENT OF LEPRA REACTIONS:
Management of Type 1 Lepra reaction:
Prednisolone tablets issued must be entered in ‘prednisolone card’.
Tapering of Prednisolone may be done according to its response.
Patient must be instructed on salt restriction.
Contra-Indicated on empty stomach.
10. Management of Type 2 Lepra Reaction (ENL):
Adding Clofazimine for type 2 reaction may be extremely useful for:
Reducing / withdrawing corticosteroids in patients who are dependent.
(*Clofazimine therapy should not exceed less than 12 months).
11. ADVERSE DRUG REACTIONS:
RIFAMPIN
1. Hepatitis
2. Flushing
3. Flu- like symptoms
DAPSONE:
1. Mild Haemolytic Anaemia
2. Gastric Intolerance
3. Allergic Rashes
CLOFAZIMINE:
1. Reddish-black discolouration of skin
2. Dry skin
3. Itching
4. Other GI symptoms (weight loss, nausia, anorexia).
12. THANK YOU
Courtesy:
• Training Manual (MoHFW, Govt. Of India)
• Park’s Textbook of Preventive and Social Medicine
• Harrison’s Principles of Internal Medicine
• Essentials of Medical Pharmacology (K.D.Tripathi)