01440nas a2200157   4500000000100000008004100001100000900042700001000051700001200061245008600073856005700159300001300216490000700229520103200236022001401268       2015                            d1 aFu X1 aLiu H1 aZhang F00aBorderline Lepromatous Leprosy with Type 1 (Reversal) Reactions in a Chinese Man.  uhttp://www.ajtmh.org/content/93/2/207.full.pdf+html   a207- 2090 v933 a<p>A 59-year-old man diagnosed with borderline lepromatous leprosy developed reddish patches and plaques on the face, which progressively enlarged and spread to the trunk and limbs. Other superficial nerves appeared normal.</p>

<p>Biopsy showed plasmocytic and lymphocytic infiltration in the nerve tract, and was 4+ acid-fast bacilli (AFB)–stain positive suggesting <em>Mycobacterium leprae</em>; this was confirmed by real-time polymerase chain reaction (PCR). The HLA-B*13:01 test was negative. Two weeks after rifampin, dapsone, and clofazimine (World Health Organization multidrug therapy [WHO MDT] regimen) were started, the skin lesions (hypochromic macules) became red, edematous, and enlarged. Both ulnar nerves became tender and thickened; ultrasonography showed reduction of blood flow. Collectively these findings indicated a type 1 conversion reaction (T1R).</p>

<p>One year after prednisone was started (40 mg/day for 3 months with progressive tapering), the T1R was found to be completely resolved.</p>
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