Page 158 - LECTURE NOTES

7. Leprosy reaction

In leprosy, there is leprosy reaction manifested by inflammation of the skin caused
by immunological reaction to the bacteria. Two types of reaction occur. Type I

(reversal reaction) and type II erytyhema nodule leprous

Type I is common in PB leprosy, present with inflammation in the skin patches with

swelling, redness, warmth and there is some discomfort and painful. There may be
inflammation of peripheral nerves with pain.

8. How to examine leprosy patches and reaction
¾ Cheek the sensation by instructing the patient to cloth his eyes

¾ Examine the paten for sign of inflammation (swelling redness, heat and pain)

¾ Examine the hand and feet for sign of loss of sweat
9. Management

¾ Make sure that the patient is leprosy case and if so, refer him/her to health center to

start patient on MDT.
¾ If you detect leprosy reaction refer patient for prednsolone treatment

¾ In the mean time, encourage taking rest and applying splint on affected limb to

restore muscle tone.
¾ If the patient has wound, clean the wound with warm water and soap and put clean

gauze or pads.
¾ If patient has loss of sensation on the foot advice to use foot wear

¾ Tell the patient to apply Vaseline or other vegetable oil on dry part of the skin, hands
and feet.

¾ Give health education to the patient and a family and community about the disease

¾ Teach the community, as to not discriminate and stigmatize the patient
¾ If the patient is recovered, help the patient to do passive and active exercise for

maintaining range of movement and restore muscle strength.
¾ Follow the patient condition and make sure the patient is getting the ordered

medication.

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