ABSTRACT
A 50 year male developed a discoid lesion of leprosy on the face. Inspite of Dapsone 100 mg/day and Rifampicin 600 mgm per day the disease spread to both sides of the face and forehead. It became worse with Prednisolone and Clofazimine. It cleared completely when Sultamicillin was added to the latter. This seems to be the first patient of leprosy to be treated with this combination and reported.
Subject(s)
Ampicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Drug Resistance, Multiple , Leprosy, Lepromatous/drug therapy , Mycobacterium leprae/drug effects , Penicillins/therapeutic use , Sulbactam/therapeutic use , Drug Therapy, Combination , Humans , Male , Middle Aged , Mycobacterium leprae/isolation & purificationABSTRACT
A study was undertaken in a field-based project to assess the incidence and clinical profile of relapses occurring in paucibacillary leprosy patients after adequate doses of multidrug therapy (MDT). Of the 1509 paucibacillary patients who had received not less than 6 doses of MDT (WHO regimen), 85 relapsed; a relapse rate of 5.63% (17.5/1000 person years at risk). These relapses included 12 cases with features of reversal reaction. Seventy-nine percent of the patients relapsed with skin lesions. The relapse rate was higher in borderline cases and in those with more lesions, and it was lower in those who had received dapsone for at least 6 months after cessation of MDT. Seventy-four percent of the relapses were detected between 7 and 24 months of follow up. We feel that uniform clinical criteria should be formulated for the diagnosis of relapse. Individualization of therapy, rather than adhering to a fixed duration of MDT, would be likely to achieve satisfactory cure rates and fewer relapses.
Subject(s)
Leprostatic Agents/administration & dosage , Leprosy/drug therapy , Drug Administration Schedule , Drug Therapy, Combination , Follow-Up Studies , Humans , Leprosy/microbiology , Leprosy/pathology , Leprosy, Borderline/drug therapy , Leprosy, Tuberculoid/drug therapy , RecurrenceABSTRACT
A dominant inheritance leading to development of nevoid basal cell epitheliomas on the face and follicular atrophoderma on the extremities constitute the two constant manifestations of Bazex syndrome. A patient with both manifestations on the trunk who fulfilled all the criteria for a diagnosis of nevoid basal cell epitheliomas is described. Histopathology of the basal cell cancer corresponded to that of the fibroepithelial tumor, thus differing from the more common nodular and trichoepitheliomatous presentations. Difficulty in associating the atrophoderma with a hair follicle (histologically) arises because the latter ceases to exist as a functional unit.
