ILEP Technical Bulletin 12 : Early detection and treatment of reversal reaction under field conditions (ARCHIVED)

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.