01584nas a2200217   4500000000100000008004100001260001600042653002000058653002000078653002200098653002100120653001200141653003600153100001300189700001400202700001000216700001300226245006800239520104500307022001401352       2014                            d  c2014 Apr 2310aType 2 reaction10aType 1 reaction10aReversal reaction10aLucio phenomenon10aleprosy10aErythema nodosum leprosum (ENL)1 aKamath S1 aVaccaro S1 aRea T1 aOchoa MT00aRecognizing and managing the immunologic reactions in leprosy.3 a<p>Immunologic reactions are an important aspect of leprosy that significantly impacts the course of the disease and the associated disability. Reversal reaction (type 1), erythema nodosum leprosum (type 2), and Lucio phenomenon are the 3 leprosy reactions, and they are most commonly seen in patients with the lepromatous and borderline categories of the disease. Because these forms of leprosy are the most common types seen in the United States, it is particularly important for physicians to be able to recognize and treat them. The reactions may occur before, during, or after treatment with multidrug therapy. Reversal reactions are the most common cause of nerve damage in leprosy, and erythema nodosum leprosum may also lead to neuritis. Although there have not been enough studies to confirm the most effective management regimens, treatment of reversal reaction and Lucio phenomenon with prednisone and of erythema nodosum leprosum with thalidomide and/or prednisone may help improve symptoms and prevent further disability.</p>
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