Dermato-Immunology Laboratory, Federal University of Pará, Marituba, Pará, Brazil.
Dermatology Division, Department of Internal Medicine, National Referral Center for Sanitary Dermatology and Hansen's Disease, University Hospital, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Trop Med Int Health. 2024 Apr;29(4):327-333. doi: 10.1111/tmi.13977. Epub 2024 Feb 13.
Cutaneous hyperpigmentation is one of the main adverse effects encountered in patients undergoing leprosy treatment with multidrug therapy (WHO-MDT). This adverse effect has been described as intolerable and capable of contributing to social stigma. The objectives of this study were to quantify the variation in skin colour induced by clofazimine during and after treatment and to assess the related stigma.
This observational cross-sectional study objectively measured skin colour in 51 patients by reading the individual typology angle (ITA°) with a spectrophotometer, followed by the application of the Stigma Scale of the Explanatory Model Interview Catalogue (EMIC).
Skin hyperpigmentation was observed in 100% of the individuals. They showed more negative ITA° values in lesion areas than non-lesion areas, particularly in sun-exposed regions. Clofazimine-induced cutaneous hyperpigmentation was not homogeneous and seemed to follow the lesion locations. The mean EMIC score was 18.8 points.
All patients presented skin hyperpigmentation caused by clofazimine, detectable through spectrophotometry. Hyperpigmentation strongly impacted the social domain, indicating the intersectionality of disease and skin colour stigma, contributing to the social isolation of these patients. Health authorities should consider the negative impact of clofazimine on treatment adherence.
皮肤色素沉着是接受世界卫生组织多药疗法（WHO-MDT）治疗的麻风病患者遇到的主要不良反应之一。这种不良反应被描述为难以忍受，并可能导致社会耻辱。本研究的目的是量化氯苯吩嗪治疗期间和治疗后引起的皮肤颜色变化，并评估相关的耻辱感。
本观察性横断面研究通过分光光度计读取个体典型角度（ITA°）客观测量了 51 名患者的皮肤颜色，随后应用解释模型访谈目录（EMIC）的耻辱量表。
100%的个体出现皮肤色素沉着。病变区域的 ITA°值较非病变区域更负，尤其是在暴露于阳光下的区域。氯苯吩嗪引起的皮肤色素沉着不均匀，似乎遵循病变部位。EMIC 评分的平均值为 18.8 分。
所有患者均出现氯苯吩嗪引起的皮肤色素沉着，可通过分光光度计检测到。色素沉着强烈影响社会领域，表明疾病和皮肤颜色耻辱之间的交叉性，导致这些患者的社会隔离。卫生当局应考虑氯苯吩嗪对治疗依从性的负面影响。
