Type 1 (reversal) reaction

Leprosy Mailing List, September 15th, 2008

Ref.: Type 1 (reversal) reaction
From: van Brakel W., Amsterdam, Netherlands


Dear Dr. Ranawaka,

I refer to you paper dated LML Aug. 25th, 2008. Yes, recurrent type 1 reaction (T1R) is well-known in lepromatous leprosy. This is then assumed to be the 'sub-polar' type, but I wouldn't claim I could tell the difference between polar and sub-polar, nor is it relevant to treatment. T1R in multibacillary (MB) leprosy should be treated with a longer course of steroids; 6 months is recommended (see e.g. Becx-Bleumink & Berhe, Int Lep J, 1992 and Rao et al, Leprosy Rev 2006). Recurrence during and just after tapering of steroids is often seen and was also documented in our recent INFIR Cohort Study in India, though we have not published specifically on recurrent reaction yet.

With friendly greetings,

Wim

Wim H. van Brakel
KIT Leprosy Unit
Wibautstraat 137
J1097DN Amsterdam
Netherlands
+3120 6939297
w.v.brakelatkit.nl
www.kit.nl