Undergraduate Medical Seminar Department of Preventive and Social Medicine Viswabarati Medical College, Kurnool

1. TREATMENT AND
MANAGEMENT OF
LEPROSY
- D.VIGHNESH
(4th Sem)

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.

3. CLASSIFICATION OF LEPROSY CASES

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.

6. MDT REGIMENS based on age and type of bacilli:

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

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)