Leprosy
Mailing List, September 15th, 2008
Ref.: Type 1 (reversal)
reaction
From: van Brakel W.,
Amsterdam
,
Netherlands
Dear Dr.
Ranawaka,
I refer to
you paper dated LML Aug. 25th, 2008. Yes, recurrent type 1 reaction
(T1R) is well-known in lepromatous leprosy. This is then assumed to be the
'sub-polar' type, but I wouldn't claim I could tell the difference
between polar and sub-polar, nor is it relevant to treatment. T1R in multibacillary (MB)
leprosy should be treated with a longer course of steroids; 6 months
is recommended (see e.g. Becx-Bleumink & Berhe, Int Lep J, 1992
and Rao et al, Leprosy Rev 2006). Recurrence
during and just after tapering of steroids is often seen and was also
documented in our recent INFIR Cohort Study in India, though we have
not published specifically on recurrent reaction yet.
With friendly
greetings,
Wim
Wim H. van Brakel
KIT Leprosy Unit
Wibautstraat 137J
1097DN
Amsterdam
Netherlands
+3120 6939297
w.v.brakel@kit.nl
www.kit.nl
