ABSTRACT
La lepra es una enfermedad infecciosa crónica propia de países de áfrica, Asia, Oceanía y América Latina. Es causada por el Mycobacterium leprae que se manifiesta de forma variada como zonas de hipo o anestesia, máculas hipocrómicas, con o sin engrosamiento neural. En algunas ocasiones, después de haber completado el ciclo terapéutico recomendado por la Organización Mundial de la Salud, puede presentar recidivas, apareciendo nuevas lesiones clínicas o aumentando el índice bacilar. Esta características pueden confundirse con el eritema nodoso leproso, caracterizado por ser una reacción antígenoanticuerpo que fija complemento mediante la cual el sistema inmune combate antígenos bacilares. En este texto se describe un caso de recidiva de lepra lepromatosa y lesiones compatibles con eritema nodoso leproso después de haber sido tratado con poliquimioterapia.
Leprosy is a chronic infectious disease endemic to African, Asian, Latin America and South Pacific countries. It is caused by Mycobacterium leprae that manifests itself as varied as areas of hypo or anesthesia, macules hypochromic, with or without neura thickening. On some occasions, after having completed the course of therapy recommended by the World Health Organization, it can recur, showing new clinical lesions or increasing the bacillary index. These features can be confused with erythema nodosum leprosum, characterized by an antigenantibody reaction that secures a complement through which the immune system combats antigen cells. This text describes a case of recurrence of lepromatous leprosy and lesions compatible with erythema nodosum leprosum after it has been treated with combination chemotherapy.
Subject(s)
Humans , Leprosy , Recurrence , Drug Therapy, Combination , Erythema NodosumABSTRACT
BACKGROUND: There were no effective methods to monitor the treatment of leprosy. Anti-PGL-1 ELISA test and polymerase chain reaction(PCR) were used for monitoring the treatment, however many restrictions have been found to apply to those methods in the field. Bacillary index(BI) is a popular and not an expensive method. For this reason, the exact data to assess the efficacy of the standard multi-drug therapy(MDT) with BI is required for evaluation of the treatment in Korea. OBJECTIVE: The purpose of this study was to clarify the change of bacillary index during MDT in multi-bacillary leprosy(MB) cases. METHODS: A total of 72 patients in the National Sorokdo Hospital were included in this study. With the retrospective method, BI, type of leprosy, relapse, age, and duration of treatment were evaluated. RESULTS: The results were as follows; 1.In this study, the mean duration of BI changing from 6 to 5 was 5.7 months, from 5 to 4 was 6.6 months, from 4 to 3 was 13.1 months, from 3 to 2 was 13.8 months, from 2 to 1 was 12.4 months, from 1 to 0 was 29.4 months. 2.The time of initial change of BI after MDT were as follows: within 3 months(26.4%), 4-6 months(29.2%), 7-12 months(26.4%), 13-18 months(8.3%), 19-24 months(4.2%), 25-48 months(5.5%). The mean duration was 8.9 months. 3.The mean cumulative time of BI to 0 was 68.4 months CONCLUSION: These results suggest that after MDT, in most of MB, BI decreased within one year and it took 68.4 months for BI to be 0. At first, BI decreased relatively fast, however a longer period was required to become a state of BI 0.