Lepra Reaction

Overview

Lepra reaction are events superimposed on the cardinal features of leprosy due to immune reaction. Though leprosy is a chronic disease, sudden appearance of signs and symptoms might occur during reactions. There are 2 of lepra reactions which are type 1 and 2, in which one is reversal and the other one erythema nodosum leprosum.

Signs and Symptoms

Painful tender nerves, Loss of function, Swollen skin lesions, New skin lesion, Tender papules and nodules, Iritis, Orchitis, Lymphadenitis, Fever, Edema

Common Causes

Immunological reaction during leprosy infection

Risk Factors

Multiple lesions, Increasing age, Lesions close to the peripheral nerve (predisposes to neuritis), Lesions on the face, People with nerve thickening with/without functional impairment, Psychological stress

Investigation Techniques

Cardinal sign of leprosy through physical examination, Slit skin smear/typical histology in a skin biopsy: to find acid fast bacilli

Treatment and Prevention

Moderate reaction, Reassurance: Patient is reassured that it will subside within few weeks with medicine, Start chemotherapy, Analgesics and Anti- inflammatory agents: Mild cases of both the types of reactions are treated symptomatically with NSAIDs., Severe reaction:, Bed rest, Rest to the affected nerve using splint, Analgesics, Thalidomide or prednisolone for 1-6 months, Counselling.,