Sung Sarah M, Kobayashi Todd T
Johns Hopkins Hospital, Department of Dermatology, 1500 Orleans St, Baltimore, MD 21231, USA.
Cutis. 2015 Apr;95(4):222-6.
Leprosy is a chronic granulomatous infection caused by the organism Mycobacterium leprae that primarily affects the skin and peripheral nerves. Leprosy has several distinct clinical presentations ranging from moderate to severe, with the extent of disease generally depending on the host's immune response to the infection. Treatment typically involves antimicrobials (eg, clofazimine, dapsone, rifampin). Once treatment is started, an important aspect of patient care is the recognition of possible reversal reactions. We report the case of a 44-year-old man who repeatedly developed physical findings consistent with a type 1 (reversal) reaction after undergoing multiple treatments for leprosy. A discussion of leprosy along with its clinical manifestations, treatment methods, and management of reversal reactions also is provided.
麻风病是由麻风分枝杆菌引起的一种慢性肉芽肿性感染,主要影响皮肤和周围神经。麻风病有几种不同的临床表现,从中度到重度不等,疾病的严重程度通常取决于宿主对感染的免疫反应。治疗通常包括使用抗菌药物(如氯法齐明、氨苯砜、利福平)。一旦开始治疗,患者护理的一个重要方面是识别可能出现的逆转反应。我们报告了一例44岁男性病例,该患者在接受多次麻风病治疗后反复出现符合1型(逆转)反应的体格检查结果。本文还对麻风病及其临床表现、治疗方法和逆转反应的管理进行了讨论。