Are leprosy reactions autoinflammatory diseases?

ABSTRACT

There are two types of leprosy reactions reversal reactions or type 1 and erythema nodosum leprosum or type 2. Deformity and disability associated with leprosy are frequently the result of uncontrolled or untreated reactions. Although there is current availability of glucocorticoids as the mainstay of therapy, much needs to be learned about the etiology, risk factors, and pathogenesis of leprosy reactions. There is some evidence that leprosy reactions may represent, particularly, erythema nodosum leprosum autoinflammatory disease due to the aberrant activation of the innate immune system. The role for herpesviruses influencing autophagy in macrophages needs to be evaluated in the pathogenesis of leprosy reactions.