Leprosy Mailing List, December 2nd, 2008
Ref.: Steroid therapy in the management of reactions in leprosy.
From: de Koning P., Würzburg, Germany
Dear colleagues,
The guidelines for treatment of leprosy reactions urgently need to be reviewed. For treatment in the field 12 weeks of prednisolone (in blister packs) is recommended by WHO for both type I and type II reactions. Evidence suggests that this is either not long enough (for type I) or too long and with an insufficiently high starting dose (type II).
For “severe reaction“ the recommendation is that a patient should be referred to experts and treated for “3-6 months“. However, these experts are becoming increasingly rare, and most health workers at grass root level follow the 12-week guideline, which is probably as good as doing nothing at all.
Kind regards,
Dr. Pieter de Koning
Medical Advisor
DAHW, Würzburg, Germany
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