Résumé
Relapse may be caused either by persisters or through reinfection in a patient released from treatment after MDT. Differentiating relapse from reversal reaction is not always easy, on histological and clinical grounds. A therapeutic trial with steroids for 2-4 weeks can be used to differentiate relapse from reversal reaction occurring in the skins. However, if a patient develops nerve function deficit after release from treatment, it is best to initiate antileprosy treatment along with a long course of steroids.
Sujets)
Biopsie , Diagnostic différentiel , Association de médicaments , Humains , Immunité cellulaire , Lèpre interpolaire/traitement médicamenteux , Lèpre lépromateuse/traitement médicamenteux , Lèpre tuberculoïde/traitement médicamenteux , Mâle , Nerfs périphériques/anatomopathologie , Récidive , Peau/anatomopathologieRésumé
Out of 92 Pauci-bacillary leprosy patients treated with MDT (WHO 1982), two patients developed indisputable clinical signs of relapse during 10th and 26th month of observation period. Two more patients developed reversal reaction during 8th and 12th month of observation period, which we presume to be early manifestation of relapse. Addition of a more bactericidal drug, rifampicin, appear to have a bearing on the incidence of relapse, though not on it's incubation period. No change of classification was noticed at the time of relapse. Incidence of relapse in female patients was much higher than in male patients.
Sujets)
Dapsone/administration et posologie , Association de médicaments , Femelle , Humains , Lèpre/traitement médicamenteux , Mâle , Récidive , Rifampicine/administration et posologie , Facteurs sexuelsRésumé
55 B.T. patients were treated with WHO Paucibacillary MDT (1982). The patients suffered from reversal reaction neither at the time of initiation of MDT nor prior to that. During the 6 months period of MDT, one patient developed reversal reaction of a skin patch, and another patient developed neuritis of a peripheral nerve trunk.