Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California.
Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California.
J Am Acad Dermatol. 2014 Oct;71(4):795-803. doi: 10.1016/j.jaad.2014.03.034. Epub 2014 Apr 24.
Immunologic reactions are an important aspect of leprosy that significantly impacts the course of the disease and the associated disability. Reversal reaction (type 1), erythema nodosum leprosum (type 2), and Lucio phenomenon are the 3 leprosy reactions, and they are most commonly seen in patients with the lepromatous and borderline categories of the disease. Because these forms of leprosy are the most common types seen in the United States, it is particularly important for physicians to be able to recognize and treat them. The reactions may occur before, during, or after treatment with multidrug therapy. Reversal reactions are the most common cause of nerve damage in leprosy, and erythema nodosum leprosum may also lead to neuritis. Although there have not been enough studies to confirm the most effective management regimens, treatment of reversal reaction and Lucio phenomenon with prednisone and of erythema nodosum leprosum with thalidomide and/or prednisone may help improve symptoms and prevent further disability.
免疫反应是麻风病的一个重要方面，它显著影响疾病的进程和相关残疾。反转反应（1 型）、结节性红斑麻风（2 型）和 Lucio 现象是 3 种麻风反应，它们最常见于瘤型和边界型麻风病患者中。由于这些形式的麻风病在美国是最常见的类型，因此医生能够识别和治疗它们尤为重要。这些反应可能在多药治疗之前、期间或之后发生。反转反应是麻风病中导致神经损伤的最常见原因，结节性红斑麻风也可能导致神经炎。尽管还没有足够的研究来证实最有效的管理方案，但用泼尼松治疗反转反应和 Lucio 现象，用沙利度胺和/或泼尼松治疗结节性红斑麻风可能有助于改善症状并防止进一步残疾。
