Leprosy Mailing List – January 26, 2014
Ref.: (LML) Facial Erythematous Patches
From: V V Pai, Mumbai, India
Dear Dr Pieter
This has reference to the LML dated 10-1-2014 from Dr PN Rao regarding persistent facial patches which pose a therapeutic challenge. We regularly come across such cases at our referral Center, with type I reaction / persistence of lesions on face which is a clinical problem. In our experience patients with type I reaction respond well to a course of steroids but in some lesions persist with erythema. This is also seen in some cases where lesions are generalised including lesions on face and those on the trunk and back respond well while lesions on the face persist for a longer time. Whether photo sensitivity plays a role in persistence of the lesions on face is an area of research.
I agree with Dr Kar therefore that sunscreens are necessary to control the erythema and prevent flare up of the lesions on face. We have observed that such persistent lesions on the face need to be treated with a course of steroids and Clofazimine in anti inflammatory doses, which should be given for six months in tapering manner. One such patient among many others benefited with this regimen is enclosed.
I have published my observations in this regard in Int Journal of Leprosy, Vol 70, No 4, P-120A, Dec 2002.
Dr V V Pai
Director
Bombay Leprosy Project
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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