Position statement: LEPROSY: Diagnosis, treatment and follow‐up

Abstract

Background Leprosy or Hansen's disease is a chronic infection caused by Mycobacterium leprae (M. leprae) or Mycobacterium lepromatosis (M. lepromatosis). In Europe, most of the leprosy cases are imported. However, occasionally a case is diagnosed in one of the old endemic foci. Leprosy is often not suspected because it is no longer emphasized in the medical curricula. Attention shifted from leprosy to tuberculosis and human immunodeficiency virus infections in the late 20th century, whereby the WHO leprosy programme was toned down in the conviction that leprosy was all but eliminated. The result of unawareness is a harmful doctor's delay. Material and methods This paper focusses on clinical diagnosis, complications and treatment based on literature and experience. Results It mentions the value of laboratory tests in classification, follow‐up and detection of relapses. It discusses the etiopathology. Conclusion This is a position statement.

Type 2 leprosy reaction resembling Sweet syndrome: Review of new and published cases

“…Regarding treatment, most patients were treated with systemic steroids (mainly prednisolone) and WHO multibacillary treatment. Refractory illness may be treated with thalidomide . In countries with a low incidence of leprosy, these type of manifestations could be overlooked and treated only with steroids.…”

“…All tissues can develop inflammation, including nerves, lymph nodes, eyes, joints and gonads. This is accompanied by fever and leukocytosis …”

“…Pre‐existing lepromatous lesions develop erythema, oedema and enlargement. Some of these may ulcerate . There is also nerve inflammation, arthralgias and acral oedema .…”

“…Some of these may ulcerate . There is also nerve inflammation, arthralgias and acral oedema . This type of reaction, usually, does not have systemic symptoms .…”

Comments to the letter to the editor by Dr Sweta Subhadarshani

“…Editor, We thank Dr Sweta Subhadarshani for her compliments 1 and for her suggestions to our article. 2 We would like however to make a few comments. She is right that there are more presentations of clinical leprosy than what we have mentioned in our paper.…”