Macular reversal reaction in leprosy: a case report

Authors

  • Flávia Cury Rezende Flávia Cury Rezende: Residente da Faculdade de Medicina do ABC – FMABC.
  • Beatrice Martinez Zugaib Abdalla Acadêmica da Faculdade de Medicina do ABC.
  • Cintia Botelho Silveira Médica especialista em dermatologia pela Sociedade Brasileira de Dermatologia.
  • Priscilla Guedes Pecoroni de Almeida Associada titular da Sociedade Brasileira de Dermatologia.
  • Fernanda Fagioli Bombonatti Associada titular da Sociedade Brasileira de Dermatologia.
  • Lúcia Ito Professora auxiliar de ensino da disciplina de dermatologia da Faculdade de Medicina do ABC – FMABC.
  • Carlos d’Apparecida Santos Machado Filho Professor Titular da disciplina de dermatologia da Faculdade de Medicina do ABC - FMABC, doutor em dermatologia pela Escola Paulista de Medicina.

DOI:

https://doi.org/10.47878/hi.2014.v39.36188

Keywords:

Leprosy, Multibacillary Leprosy, Cellular Immunity

Abstract

Macular reversal reaction is the abrupt onset of hypochromic lesions, occurring in borderline leprosy patients who completed treatment with multidrugtherapy for multibacillary leprosy. In general, these reactions appear 6 to 12 months after medical discharge, showing negative skin smear and good response to systemic corticosteroid therapy. We emphasize the difficulty in differentiating relapse casesfrom leprosy reactions, as there are no well-established clinical criteria that allow this diagnosis, and moreover there are few reports about it in the literature. We report a borderline leprosy case diagnosed with macular reversal reaction after variable period of discharge from treatment. Detailed anamnesis, dermatological and histopathological examination and bacilloscopy, analysis of previous medical records, excluding the relapse criteria, were used for the investigation. The patient was submitted to systemic corticosteroid therapy, with improvement of the lesions. It is concluded that macular reversal reaction should be considered in the differential diagnosis of relapsed leprosy and classic reactional episodes, avoiding unnecessary re-treatment.

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References

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Published

2014-11-30

How to Cite

1.
Rezende FC, Abdalla BMZ, Silveira CB, Almeida PGP de, Bombonatti FF, Ito L, Machado Filho C d’Apparecida S. Macular reversal reaction in leprosy: a case report. Hansen. Int. [Internet]. 2014 Nov. 30 [cited 2024 Jul. 22];39(2):70-4. Available from: https://periodicos.saude.sp.gov.br/hansenologia/article/view/36188

Issue

Vol. 39 No. 2 (2014)

Section

Seção anátomo-clínica

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

This journal is licensed under a Creative Commons Attribution 4.0 International License.