Leprosy mailing list – July 14th,
2006
Ref.: Can leprosy
skin lesions heal and disappear, under treatment, in 3-6 months?
From:
Shen J., Nanjing, Jiangsu,
People’s Democratic Republic of China
Dear Dr Noto,
Thank Dr Jean Felly M. and you for giving
us this interesting question: "Can
leprosy skin lesions heal and disappear, under treatment, in 3-6
months? This is a delayed
response. I have already
seen that there have many answers about this issue. But I would like to give my
comment based on my clinical leprosy experiences for more than 30
years in China.
Leprosy patches healed totally without leaving
even residual margin can really happen some time. But this is a miracle if
happened in a 3-6 months. The
patients must be at his very early stage of disease without impairment
of skin sensation and the skin smear must also be negative. So he must not be BT, BB, BL
or LL leprosy and he must be an indeterminate leprosy.
In high endemic areas having many patients with a single skin lesion,
leprosy patches healed without leaving residual margin in a short time
can be seen by some field doctors.
However it is rare and is a miracle as I said before. If Dr Jean Felly M saw many
patients without residuals of skin patch during checking up the
patients, and there were not many patients with a single skin lesion
at diagnosis, I think there may be many false patients.
How to confirm these true or false
patients with leprosy, I can first tell you a story about one
patient I met. The
patient denied leprosy when his skin patch disappeared after treatment
for many years. He wants
the doctor to compensate his loss because he lost his work after
doctor diagnosed and treated his leprosy. We carefully checked up the
skin lesion and made a biopsy at the previous site of the skin lesion
according the medical history. The
examination of the biopsy showed that the epidermis of the skin had a
slight atrophy, and the sweat glands and hair follicles in the dermis
also had a slight atrophy. We
told the patients this was an evidence that he had a leprosy before
and cannot be denied. The
patient at last was persuaded not to ask compensation from the doctor.
So I consider that Dr Jean Felly M can also use
biopsy to look for the residual mark of leprosy which can provide the
some useful clue of disease the patient had before. I hope this can provide you
some useful information.
With best regards,
Dr Shen Jianping
