Oliveira Marcela Bahia Barretto de, Diniz Lucia Martins
Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
An Bras Dermatol. 2016 Apr;91(2):196-203. doi: 10.1590/abd1806-4841.20163661.
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, representing a public health issue in some countries. Though more prevalent in adults, the detection of new cases in children under 15 years of age reveals an active circulation of bacillus, continued transmission and lack of disease control by the health system, as well as aiding in the monitoring of the endemic. Among patients under 15 years of age, the most affected age group is children between 10 and 14 years of age, although cases of patients of younger than 1 year of age have also been reported. Household contacts are the primary source of infection, given that caretakers, such as babysitters and others, must be considered in this scenario. Paucibacillary forms of the disease prevailed, especially borderline-tuberculoid leprosy, with a single lesion in exposed areas of the body representing the main clinical manifestation. Reactional states: Lepra reactions are rare, although some authors have reported high frequencies of this phenomenon, the most frequent of which is Type 1 Lepra Reaction. Peripheral nerve involvement has been described at alarming rates in some studies, which increases the chance of deformities, a serious problem, especially if one considers the age of these patients. The protective effect of BCG vaccination was found in some studies, but no consensus has been reached among different authors. Children must receive the same multidrug therapy regimen and the doses should, ideally, be calculated based on the child´s weight. Adverse reactions to this therapy are rare within this age group. This article aims to review epidemiological, clinical, and therapeutic aspects of leprosy in patients under 15 years of age.
麻风病是由麻风分枝杆菌引起的一种慢性传染病，在一些国家是一个公共卫生问题。虽然在成年人中更为普遍，但15岁以下儿童中新病例的发现表明杆菌在活跃传播、疾病持续传播以及卫生系统缺乏疾病控制，同时也有助于对地方病进行监测。在15岁以下的患者中，受影响最大的年龄组是10至14岁的儿童，不过也有1岁以下患者的病例报告。家庭接触者是主要感染源，因为在这种情况下必须考虑保姆等照顾者。少菌型麻风病较为常见，尤其是界线类偏结核样型麻风，身体暴露部位出现单个皮损是主要临床表现。反应状态：麻风反应很少见，尽管一些作者报告了这种现象的高发生率，其中最常见的是1型麻风反应。一些研究以惊人的比例描述了周围神经受累情况，这增加了出现畸形的几率，这是一个严重问题，尤其是考虑到这些患者的年龄。一些研究发现卡介苗接种有保护作用，但不同作者尚未达成共识。儿童必须接受相同的多药治疗方案，理想情况下，剂量应根据儿童体重计算。该年龄组对这种治疗的不良反应很少见。本文旨在综述15岁以下患者麻风病的流行病学、临床和治疗方面。
