(LML) Newly Developed Model Patient Card/Record (Leprosy) by ILEP Technical Commission (ITC)

Leprosy Mailing List – January 21,  2014 

Ref.:  (LML)   Newly Developed Model Patient Card/Record (Leprosy) by ILEP Technical Commission (ITC)

From:  Felicity Bonham, ILEP, London, UK

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Dear Pieter,

On behalf of Mr Douglas Soutar, General Secretary of ILEP and Secretary to the ILEP Technical Commission (ITC), I am sending a link to a model patient card/record developed by the ITC in response to demand. ILEP now recommends this can be taken as reference when leprosy endemic countries are developing or modifying their leprosy patient cards at national, sub-national and institutional levels: http://goo.gl/QGaiOw

This has been developed in response to need and a specific request made at the WHO Western Pacific Region’s Meeting of National Leprosy Programme Managers in early 2012.

 With advance thanks and all best wishes,

 Felicity

 

Felicity Bonham

PA to the General Secretary

International Federation of Anti-Leprosy Associations
Working together for a world without leprosy

Tel: +44 (0)20 7602 6925 – Fax: +44 (0)20 7371 1621 – Website: www.ilep.org.uk

To get our updates, like us on Facebook: ILEPAntiLeprosy

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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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(LML) Facial Erythematous Patches

Leprosy Mailing List – January 21,  2014 

Ref.:    (LML) Facial Erythematous Patches

From:   H K Kar, New Delhi, India

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Dear Dr Pieter,

 

Referring to the letter of Dr. Rao concerning facial erythematous patches: we often encounter such problems of persistence of erythema on old treated patches of PB cases who also had history of type 1 reactions (T1R) for months together, particularly if the lesion is on the face.

 

If the histopathological examination after RFT still shows the features of T1R, few weeks of oral steroid is required instead of local steroid application. In addition, I always prefer to prescribe Sun blocking agent local application, (best is  calamine with zinc lotion) over the face to protect the lesion from UV light. The erythema very slowly disappears after a period of few months. In case of no histopathological features of T1R, only local calamine application is sufficient which should be applied for few months. Local application of topical calcineurin inhibitors like tacrolimus or pimecrolimus is worth trying at night.

 

Regards,

 

 

Dr (Prof.) H K Kar
Director and Med. Superintendent
P.G.I.M.E.R. and Dr Ram Manohar Lohia Hospital
Baba Kharag Singh Marg
New Delhi-110001

 

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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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(LML) Facial Erythematous Patches

Leprosy Mailing List – January 21,  2014 

Ref.:    (LML) Facial Erythematous Patches

From:  Thomas H. Rea, Los angelos, California, USA

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Dear Dr. Scheuder,

Concerning Dr. Rao's patients: both photos show an erythema with a distinct purplish cast which we see not uncommonly in our Mexican-born patients who are having a reversal reaction.  The sharp margin in the gentleman patient is also consistent with a reversal reaction.  The lady appears to have edema of her lower lip, which might be attributed to a reversal reaction.  Biopsy is needed for definitive classification.

Regards,

 

Thomas H. Rea, M.D.

 

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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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(LML) Dapsone syndrome

Leprosy Mailing List – January 19,  2014 

Ref.:    (LML) Dapsone Syndrome

From:  Ben Naafs, Munnekeburen, the Netherlands

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Dear dr Jingquan Wang,

 

 

Thank you for your health wishes.

 

I think you treated indeed a dapsone syndrome and you were treating it well. The exfoliating dermatitis may come later than the other symptoms. After stopping the MDT and diminishing the steroids the immunity came back and the antigenic determinants were detected again and the original lesions showed again inflammation. This is visible. The ulceration I cannot explain. But I think will heal by itself.

 

Treat as new leprosy with a reversal reaction but refrain from dapsone. So treat with clofazimine and for instance minocyclin beside the rifampicin. Treat he reversal reaction with steroids for at least 6 months.

 

With regards,

 

 

Ben Naafs

 

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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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(LML) Dapsone syndrome

Leprosy Mailing List – January 19,  2014 

Ref.:    (LML) DDS syndrome

From:  David M. Scollard,  Baton Rouge, Louisiana, USA

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Dear Pieter,

Regarding the dapsone syndrome, the following article was published recently in the New England Journal of Medicine, describing a genetic association with this syndrome.  The research was done in China and it appears that individuals of Chinese ancestry may be more likely to carry the allele(s) that put them at risk for this syndrome.

Zhang F.-R., Liu H., Irwanto A., et al.

HLA-B*13:01 and the Dapsone Hypersensitivity Syndrome

N Engl J Med 2013; 369:1620-1628

Dapsone is an important medication for the treatment of leprosy, but a life-threatening drug hypersensitivity syndrome develops in some patients. In this report from China, an HLA-B locus is identified as a strong genetic risk factor for the syndrome.

 

Best wishes,

David

David M. Scollard, M.D., Ph.D.

Director

National Hansen’s Disease Programs

Tel:  225-756-3713 or 225-756-3776

Fax:  225-756-3819 (Clinical) or 225-756-3806 (Administration)

E-mail:  dscollard@hrsa.gov

Web:  www.hrsa.gov/hansens                 

Online Course:  http://www.hrsa.gov/hansensdisease/onlinecourseawareness.html

 

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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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(LML) Dapsone syndrome

Leprosy Mailing List – January 19,  2014 

Ref.:    (LML) Dapsone syndrome

From:  Aguinaldo Gonçalves, Unicamp, Brazil

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Dear Pieter,

First of all, a good and prosperous 2014 for everybody!

Thanks to your friends for the opportunity to share Doctor Wang' case. I would like to submit two short suggestions:

1- I could consider the possibility of applying some local healing stimuli, such  as laser therapy exposure(1) on the ulcerative lesion;

2- I don't know the conditions of the Chinese  prisons, but  it seems reasonable to  me to look for contacts (by skin, infusion  or drinking) with drugs that can promote leprosy reactions. Here in Brazil we have some experience with iodine products provoking ENL. I remember a published case of an alcohol addicted prisoner I have seen some years ago: working  as nursing auxiliary, he died because of repeatedly continuous mercurochrome ingestion.

Best regards,

Aguinaldo

Prof. Dr. Aguinaldo Gonçalves, MD, MSc, PhD
Full Professor, Public Health & Physical Activity, Unicamp, Brazil
A2 Researcher Professor, Preventive and Social Medicine,  PUC Campinas, Brazil
aguinaldogon@uol.com.br

Former National Director, Divison of Sanitary Dermatology, Ministry of Health
http://lattes.cnpq.br/8140651861738248

Ref.: (1) GONÇALVES G, GONÇALVES A, PADOVANI CR, PARIZOTTO NA.  Laser therapy applied to leprous and non-leprous ulcers healing: a clinical trial in out-patient units of Public Health Service  Hansenologia Inter. 2000, 25(2): 133-142, .

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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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(LML) Nerve damage in leprosy: a case report

Leprosy Mailing List – January 13,  2014 

Ref.:    (LML) Nerve damage in leprosy: a case report.

From:  Salvatore Noto and Andrea Clapasson, Genua, Italy

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Dear Pieter,

 

In attachment there is a PDF document with pictures of a lady with leprosy seen in Genoa, Italy. She is 41 years old and comes from Nigeria. The first seven pictures are clinical; the last two are histopathology images from biopsy of the sural nerve.

 

Skin lesions are vague and not easily recognized. There is advanced damage of the median, ulnar and posterior tibial nerves.

 

Thank you very much for circulating it to the leprosy mailing list. Any comment is welcome.

 

Salvatore Noto and Andrea Clapasson

 

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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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