Leprosy Mailing List – March 6, 2016
Ref.: (LML) 19th International Leprosy Congress Beijing 2016
From: Geeske Zijp, Mongo, Chad
Dear Dr. Schreuder,
Ben Naafs (LML February 4, 2016) asked us to come with questions on clinical leprosy.
When concerning the WHO-grading, 5 or less skin patches means PB-leprosy. We do occasionally have patients with 5 or less patches but many of them have more than one enlarged nerve. Recently a new patient, having mistreated himself with traditional medicine, was detected by our team in his village with (severe) leprosy reaction on multiple nerves. The patient was put on MDT PB but we decided later on, to put him on MB treatment since he presented reaction symptoms on multiple nerves.
My question is, what is the guideline? What is the criteria in regard to nerve involvement (hypertrophy) for classification PB or MB (when skin patches are 5 or less?). Is there a standard answer on this?
NB: we are working in very basic field conditions, without the possibility to do routine laboratory work (skin smears only in the capital, nerve biopsies outside the country I believe).
With kind regards,
Geeske Zijp
TLM-programme manager for Chad
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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