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7.3 General Treatment of Leprosy

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Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. It mainly affects the skin, the peripheral nerves and the mucous membranes. Leprosy is the commonest cause of peripheral neuritis in the world.

Diagnostic Criteria

  • Hypo pigmented anaesthetic macula or nodular and erythematous skin lesions
  • Nerve thickening.
  • Burning sensations in the skin
  • Numbness and tingling of the feet and/or hands
  • Weakness of eyelids, hands or feet
  • Painless swellings or lumps in the face and earlobes
  • Painless wounds or burns on the hands or feet

Presence of any one among the three cardinal signs of leprosy below:

  • Skin patch with loss of sensation
  • One or more enlarged peripheral nerves
  • Presence of leprosy bacilli–positive smear

Classification of Leprosy

Multibacillary (MB) Leprosy

  • Patients with six or more leprosy skin lesions
  • Positive skin smear

Paucibacillary (PB) Leprosy

  • Patients with one to five leprosy skin lesions
  • Negative skin smear

Note: If there is any doubt regarding the classification, the patient should be classified and treated as a multi-bacillary case.

Pharmacological Treatment

Patients should be treated by multidrug combination therapy; dosage may depend with classification and whether patient is adult or children

Table 7.6 Treatment of Leprosy

Classification Medicine dosage Duration of

treatment

Adult MB: 15 years and above Day 1: Rifampicin 600mg (2x 300mg) + Clofazemine 300mg (3 x 100mg) + Dapsone 100mg. Daily Treatment: Day 2–28,

Clofazemine 50mg + Dapsone 100mg

12 blister packs to be taken within a period of between 12–18

months

Child MB: below 15yrs Day 1: Rifampicin 450mg (3 x 150mg) + Clofazemin 150mg (3 x 50mg) + Dapsone 50mg. Daily Treatment: Day 2–28 Clofazemine 50mg every other day + Dapsone 50mg daily. 12 blister packs to be taken within a period of between 12–18

months

 

Adult PB: 15 years and above Day 1: Rifampicin 600mg (2 x 300mg) +

Dapsone 100mg. Daily Treatment: Days 2–

28: Dapsone 100mg

6 blister packs to be taken within a period of between 6–9 months
Child PB: below 15yrs Day 1: Rifampicin 450mg (3 x 150mg) +

Dapsone 50mg. Daily Treatment: Days 2– 28: Dapsone 50mg daily

 

6 blister packs to be taken within a period of between 6–9 months

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