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KHUNADI HUBAYA
DERMATOVENEREOLOGY DEPARTMENT OF
TUGUREJO GENERAL HOSPITAL, SEMARANG,
CENTRAL JAVA, INDONESIA
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
INTRODUCTION
Leprosy Reaction
State of symptoms and signs of acute
inflammation in the lesions of
leprosy
patients
immunological disorder
caused by hypersensitive reaction of
M.leprae
antigens.
Fifty percent (50%) of treated leprosy
patients
reactions
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
Reaction occurs :
Leprosy occurs
Occur due to of immunological changes
as a result of antileprosy treatment
Occur spontaneously other infectious
diseases, anemia, mental and physical
stress, puberty, pregnancy, childbirth,
surgery.
Anti-leprosy treatment
trigger
factors
most frequent
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
down grading
to lepromatous
( decrease cellular immune
CINICAL FEATURES
Prominent and shiny erythematous
plaques, few days later, the color can
change
to purplish or
brownish. The firm edge of
the
lesion, pressurized pain or feels hot
when touched.
In severe reactions
desquamation
or
ulceration due to necrosis.
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
MANAGEMENT
Rest or immobilization
Elimination of triggering factor
Continuing treatment of anti-leprosy
drugs
Analgesic sedatives to cope with pain
Provision of anti reaction drugs
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
Mild reaction
Nonmedicamentosa: rest,
immobilization
Medicamentosa: paracetamol,
mefenamic acid, aspirin, piroxicam,
diclofenac sodium,cyclooxygenase 2
(COX 2)
Severe reaction
Improvement of general condition by
improving fluid/electrolyte balance
Must be given corticosteroid
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
Provision of Corticosteroid
Prednisone 40-60 mg/day single morning
dose, tapering slowly until a few months/
years.
Corticosteroid > one month, required
minimum
dose
and
alternate-day
treatment
Prednisone or prednisolone of 0.5 to 1.0
mg/BB kg/day single morning dose,
tapering
slowly and alternate-day
treatment is more
tolerated.
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
prednisolone 1 mg/BB
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011
leprosy
THANK YOU
PRESENTED IN THE INDONESIAN DUTCH TROPICAL DERMATOLOGY MEETING, YOGYAKARTA, APRIL 7TH - 9TH ,2011