01358nas a2200181   4500000000100000008004100001260006600042653001400108653002200122653001200144653001300156653002000169100001800189700001000207245010700217300000900324520084300333       1997                            d  bInternational Federation of Anti-Leprosy AssociationsaLondon10aTreatment10aReversal reaction10aleprosy10aEnglish 10aEarly detection1 aCommission IM1 aILEP 00aILEP Technical Bulletin 12 : Early detection and treatment of reversal reaction under field conditions  a4 p.3 a<p>Leprosy reactions are the main cause of acute nerve damage and disability in leprosy. Reactions are caused by changes in the immune response of the patient to the mycobacteria. There are two types of reaction, reversal reaction or type 1 reaction and erythema nodosum leprosum (ENL) or type 2 reaction. (ILEP Technical Bulletin 9 describes the management of ENL reaction). Reversal reactions often occur in the first 6 months of multidrug therapy (MDT) and may occur in both paucibacillary (PB) and multibacillary leprosy (MB), but more commonly in MB. Sometimes patients are found to have reversal reactions at the time of diagnosis and it may be the symptoms of the reaction which makes the patient aware of the disease. A reversal reaction may occur after completion of MDT, particularly when short duration regimens are used.</p>