Ref.: Leprosy Mailing List – July 3, 2015
Ref.: (LML) Bolus treatment and the prevention of nerve damage in Erythema Nodosum Leprosum ENL
From: Muherman Harun, Jakarta, Indonesia
Dear Pieter,
As you know, I am not at all a leprologist. But my experience with corticosteroids treatment, I first got from Leyenburg ziekenhuis The Hague. After more than 40 years now, I am still using CS for almost all of my chest patients. CS are excellent drugs if used properly, if not, they may become ‘nasty’ drugs.
Dr Zijp (LML, June 30, 2015) has a good case who had taken CS for over six months with excellent results. Eventually, patient got reaction which was cleared within 10 (?) days after CS, indicating that even short time treatment, CS had been very effective.
I have very few patients that are CS dependent, and if so, I would give the smallest maintenance dose. Six mg of prednisolone a day or every 2 days (this means 3 mg a day) is probably sufficient without side effects. But if patient insists he wants to quit CS, the dose could be reduced every other week with one mg until zero but should immediately take a bolus if reaction recurs and report to the doctor.
With due respect to Dr Ben Naafs,
Muherman Harun
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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