A patient with leprosy had slightly erythematous, anesthetic plaques on the trunk and upper limbs. He was treated with paucibacillary multidrug therapy (PB-MDT) for 6 months. At the end of 6 months, he had persistent erythema and induration in the plaque. The next step of action recommended by the World Health Organization (WHO) in such a patient is
Ans. is 'a' i.e., Stop antileprosy treatment o WHO recommends that "In paucibacillary leprosy, the multidrug therapy is stopped after 6 months of treatment regardless of the presence of clinically active disease". o According to Indian leprologists "The t/t with both Rifampicin and dapsone must be continued till all signs of activity have been subsided". o It is believed that these patients are viually always cleared of ble bacteria in 6 months with the WHO-MDT regime. o Therefore the attainment of clinical inactivity should not be the condition guiding the continuation of multidrug therapy in paucibacillary leprosy. o The lesions may be present but they will be cleared of all the organisms. o The clinical activity dos not correlate with bacterial multiplication. o Incidence of relapse in paucibacillary patients is very low and follow up studies in paucibacillary patients demonstrates that complete clearing of lesions takes 1-2 years after t/t discontinuation.
Stop antileprosy treatment
Continue PB-MDT till erythema subsides
Biopsy the lesion to document acitivity
Continue dapsoen alone for another 6 months