Leprosy · NEET PG Preparation Dermatology
A patient with lepromatous leprosy on Multi-Drug Therapy (MDT) develops painful subcutaneous nodules on the extremities, accompanied by fever, arthra…
Practice question from Leprosy (NEET PG Preparation Dermatology), with the correct answer and a step-by-step solution.
medium · MCQ · Q-A31A87
A patient with lepromatous leprosy on Multi-Drug Therapy (MDT) develops painful subcutaneous nodules on the extremities, accompanied by fever, arthralgia, and iridocyclitis. Biopsy of a nodule shows intense neutrophilic infiltrate in the deep dermis and subcutis with leukocytoclastic vasculitis. What is the most appropriate initial management for this severe reaction?
- A.Increase the dose of Rifampicin
- B.Start Thalidomide or systemic corticosteroidsCorrect answer
- C.Stop all anti-leprosy drugs permanently
- D.Administer Clofazimine in low daily doses only
Solution
The patient is experiencing a Type 2 reaction (Erythema Nodosum Leprosum - ENL), which is an immune complex-mediated condition seen in lepromatous spectrum leprosy. Severe ENL is treated with systemic corticosteroids or thalidomide (where available and legally permissible). MDT for leprosy should be continued during reactions.
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