Background: Inflamed large facial patch, being compromising the appearance and beauty of a patient, is a source of embarrassment and distress, and affects anti-leprosy drive adversely in many ways in the field situation. Its management with oral prednisolone alone, the mainstay of treatment for reversal reaction, proved disappointing. Objective: To see whether topical tacrolimus will be helpful in managing those patients. Methodology: We treated five adult patients with recurring reversal reaction in large facial patch with tacrolimus 0.1% ointment, twice daily and lower dose oral prednisolone for twelve months during March, 2012-February, 2013. Result: Complete remission was achieved in all cases. No side effects of whatsoever was seen in any patient. No recurrence of reaction is seen in any patient till to date. Conclusion: Tacrolimus ointment and lower dose prednisolone was found helpful in managing patients with recurring reversal reaction in large facial patch.
| Published in | American Journal of Clinical and Experimental Medicine (Volume 2, Issue 4) |
| DOI | 10.11648/j.ajcem.20140204.16 |
| Page(s) | 86-89 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Leprosy, Reversal Reaction, Reacting Facial Patch, Management, Tacrolimus and Prednisolone
| [1] | Job CK. Pathology of leprosy. In: Hastings RC (ed). Leprosy, 2nd edn. Churchill Livingstone, Edinburgh, 1994; pp. 193-234. |
| [2] | Richardus JH, Finlay K, Croft RP and Smith WCS. Nerve function impairment in leprosy at diagnosis and completion of MDT: a retrospective cohort study of 786 patients in Bangladesh. Lepr Rev, 1996; 67: 297-305. |
| [3] | Lockwood DNJ. Clinical features and outcome of reversal (type 1) reactions in Hyderabad, India. J Int Lepr, 1993; 61: 8-15. |
| [4] | Becx-Bleumink M, Berhe D. Occurrence of reactions, their diagnosis and management in leprosy patients treated with multidrug therapy: experience in the leprosy control program of the All Africa Leprosy and Rehabilitation Training Center (ALERT) in Ethiopia. Int J Lepr, 1992; 60: 173-184. |
| [5] | Guillermo Biosca, Sonia Casallo and Rogelio Lopez-Velez. Methotrexate treatment for type 1 (reversal) leprosy reactions. Clin Infect Dis, 2007; 45 (1): e7-e9. Doi: 10.1086/518699. |
| [6] | Frankel RI, Mita RT, Kim R and Dann FJ. Resolution of type 1 reaction in multibacillary Hensen’s disease as a result of treatment with cyclosporine. Int J Lepr Other Mycobact Dis, 1992; 60: 8-12. |
| [7] | Marlowe SN, Hawksworth RA, Butlin CR, Nicholls PG and Loockwood DN. Clinical outcomes in a randomized controlled study comparing azathioprine and prednisolone versus prednisolone alone in the treatment of severe leprosy type 1 reactions in Nepal.Trans R Soc Trop Med Hyg, 2004; 98: 602-9. |
| [8] | Gilles Safa, Laure Darrieux, Alain Coic, Laurent Tisseau. Type 1 leprosy reversal reaction treated with topical tacrolimus along with systemic corticosteroids. Indian J Med Sci, 2009; 63 (8): 359-362. |
| [9] | Rose P, Waters MFR. Reversal reactions in leprosy and their management. Lepr Rev, 1991; 62: 113-121. |
| [10] | Roche PW, LeMaster J, Butlin CR. Risk factors for type 1 reactions in leprosy. Int J Lepr, 1997; 65: 450-55. |
| [11] | Swierkot J, Szechinski J. Methotrexate in rheumatoid arthritis. Pharmacol Rep, 2006; 58: 473-92. |
| [12] | Ochoa MT, Stenger S, Sieling PA et al. T-cell release of granulysin contributes to host defense in leprosy. Nat Med, 2001; 7: 174-179. |
| [13] | Cooper RL, Mueller C, Sinchaisri T-A et al. Analysis of naturally occurring delayed type hypersensitivity reactions in leprosy by in situ hybridization. J Exp Immunol, 1989; 169: 1565-81. |
| [14] | Sullivan L, Sano S, Pirmez C et at. Expression of adhesion molecules in leprosy lesions. Infect Immun, 1991; 59: 4154-60. |
| [15] | Gupta AK, Adamiak A, Chow M. Tacrolimus: A review of its use for the management of dermatoses. J Eur Acad Dermatol Venereol, 2002; 16: 100-114. |
| [16] | Naafs B. Treatment of reactions and nerve damage. Int J Lepr, 1996; 64: S21-28. |
APA Style
Delwar Hossain. (2014). Tacrolimus in the Management of Large Facial Patch with Recurring Reversal Reaction: Outcome of a Pilot Clinical Trial Study on 5 Patients. American Journal of Clinical and Experimental Medicine, 2(4), 86-89. https://doi.org/10.11648/j.ajcem.20140204.16
ACS Style
Delwar Hossain. Tacrolimus in the Management of Large Facial Patch with Recurring Reversal Reaction: Outcome of a Pilot Clinical Trial Study on 5 Patients. Am. J. Clin. Exp. Med. 2014, 2(4), 86-89. doi: 10.11648/j.ajcem.20140204.16
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Download@article{10.11648/j.ajcem.20140204.16,
author = {Delwar Hossain},
title = {Tacrolimus in the Management of Large Facial Patch with Recurring Reversal Reaction: Outcome of a Pilot Clinical Trial Study on 5 Patients},
journal = {American Journal of Clinical and Experimental Medicine},
volume = {2},
number = {4},
pages = {86-89},
doi = {10.11648/j.ajcem.20140204.16},
url = {https://doi.org/10.11648/j.ajcem.20140204.16},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20140204.16},
abstract = {Background: Inflamed large facial patch, being compromising the appearance and beauty of a patient, is a source of embarrassment and distress, and affects anti-leprosy drive adversely in many ways in the field situation. Its management with oral prednisolone alone, the mainstay of treatment for reversal reaction, proved disappointing. Objective: To see whether topical tacrolimus will be helpful in managing those patients. Methodology: We treated five adult patients with recurring reversal reaction in large facial patch with tacrolimus 0.1% ointment, twice daily and lower dose oral prednisolone for twelve months during March, 2012-February, 2013. Result: Complete remission was achieved in all cases. No side effects of whatsoever was seen in any patient. No recurrence of reaction is seen in any patient till to date. Conclusion: Tacrolimus ointment and lower dose prednisolone was found helpful in managing patients with recurring reversal reaction in large facial patch.},
year = {2014}
}
TY - JOUR T1 - Tacrolimus in the Management of Large Facial Patch with Recurring Reversal Reaction: Outcome of a Pilot Clinical Trial Study on 5 Patients AU - Delwar Hossain Y1 - 2014/08/20 PY - 2014 N1 - https://doi.org/10.11648/j.ajcem.20140204.16 DO - 10.11648/j.ajcem.20140204.16 T2 - American Journal of Clinical and Experimental Medicine JF - American Journal of Clinical and Experimental Medicine JO - American Journal of Clinical and Experimental Medicine SP - 86 EP - 89 PB - Science Publishing Group SN - 2330-8133 UR - https://doi.org/10.11648/j.ajcem.20140204.16 AB - Background: Inflamed large facial patch, being compromising the appearance and beauty of a patient, is a source of embarrassment and distress, and affects anti-leprosy drive adversely in many ways in the field situation. Its management with oral prednisolone alone, the mainstay of treatment for reversal reaction, proved disappointing. Objective: To see whether topical tacrolimus will be helpful in managing those patients. Methodology: We treated five adult patients with recurring reversal reaction in large facial patch with tacrolimus 0.1% ointment, twice daily and lower dose oral prednisolone for twelve months during March, 2012-February, 2013. Result: Complete remission was achieved in all cases. No side effects of whatsoever was seen in any patient. No recurrence of reaction is seen in any patient till to date. Conclusion: Tacrolimus ointment and lower dose prednisolone was found helpful in managing patients with recurring reversal reaction in large facial patch. VL - 2 IS - 4 ER -
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