Reactions in Leprosy

Original article


A. J. Kanwar, M. S. Belhaj

Division of Dermatology, Department of Medicine, University of GarBenghazi, S.P.L.A.J.

Garyounis Medical Journal Vol. 5, No.1. January 1982: 63-68


Acute exacerbations of activity in the chronic, placid course of leprosy are termed as ‘Reaction’. These occur throughout the leprosy spectrum and are classified into Type 1 and Type 2. Type I reactions occur in all forms of determinate leprosy, are either UPGRADING or DO WNGRA PING in nature and are usually not accompanied by constitutional symptoms. Type 2 reactions commonly refered to as Erythema Nodosum Leprosum (ENL) occur only in LL and BL forms of disease and are accompanied by severe constitutional symptoms with serious complications threatening eyes, nerves and testes. Management of the reactions require skill and patience in addition to drugs. In Type I reactions, Dapsone is to be STOPPED while in Type 2 reaction, antileprosy drugs are to be CONTINUED in full doses. Analgesics, antimony preparation and chloroquine are of help in mild to moderate degrees of reactions while systemic steroids, clofazimine and thalidomide are the mainstay of treatment for severe reactions.

Keywords: Reactions in Leprosy