The downgrading reaction would only be an issue at first presentation

Leprosy Mailing List – May 3^rd, 2012

Ref.:   The downgrading reaction would only be an issue at first presentation.
From: H J Kawuma, Buluba, Uganda

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Dear Salvatore,

I am glad that this longstanding puzzle has come up for debate again.

Dr. Bryceson, as usual, has put the arguments clearly for many of us to appreciate [LML April 26^th, 2012].  It appears the downgrading reaction would only be an issue at first presentation as we would not expect it in a person on treatment.  Might it also be a manifestation of treatment failure?

Dr. Bryceson must be aware of the reasons behind the shift to referring to type 1 reactions as "Reversal Reactions" at some stage.  Would he kindly remind the readers of those reasons as well?

Best wishes,

H Joseph Kawuma
GLRA, Uganda