Leprosy
Mailing List, September 8th, 2008
Ref.: 20 weeks of
Prednisolone are better than 12 weeks in the treatment of type 1
(reversal) reaction
From: Kawuma H. J., Kampala, Uganda
Dear Salvatore,
I refer to the request by Dr. Ranawaka on the treatment of Type 1
(reversal) reaction (Leprosy
Mailing List, August 25th, 2008).
I wish to share the experience from
Uganda
.
Polar types of leprosy, both tuberculoid (TT) and lepromatous (LLp),
are rare in our region. We have more cases of sub-polar
lepromatous leprosy (LLs), lacking classical features of LLp.
The LLs cases were known to develop protracted and recurrent Type 1
reactions but which when well managed gave a very good result in the
end for the patient.
We learnt to use more prolonged treatment with Prednisolone and this
has been confirmed by good clinical trials. 20 weeks Prednisolone courses
are better than 12 weeks courses.
Of course we need to keep in mind other factors (already
discussed in this forum) that can precipitate recurrent reactions or
poor response to treatment.
H Joseph Kawuma
GLRA,
Kampala
,
Uganda
