Macular reversal reaction in leprosy: a case report
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Hansenologia Internationalis (Online) |
Texto Completo: | https://periodicos.saude.sp.gov.br/hansenologia/article/view/36188 |
Resumo: | 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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Macular reversal reaction in leprosy: a case reportReação reversa macular da hanseníase: relato de casoHanseníaseHanseníase MultibacilarLeprosyMultibacillary LeprosyCellular ImmunityMacular 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.A reação reversa maculosa consiste no aparecimento abrupto de máculas hipocrômicas, ocorrendo em pacientes hansenianos dimorfos que completaram o tratamento com poliquimioterapia para hanseníase multibacilar. Em geral, surgem entre 6 a 12 meses da alta, com baciloscopia negativa e boa resposta a corticoterapia sistêmica. Ressaltamos a dificuldade em diferenciar recidiva de um episódio reacional, já que não existem critérios clínicos bem estabelecidos que possibilitem este diagnóstico, além de existirem poucos relatos em literatura. Relatamos um caso clínico com diagnóstico de reação reversa macular após período variável de alta do tratamento de hanseniase dimorfa-dimorfa. Foi feita investigação por meio de anamnese rigorosa, exame dermatológico, exame histopatológico da lesão e baciloscopia, excluindo-se os critérios de recidiva, além de analisados dados anteriores do prontuário. O paciente foi submetido a corticoterapia sistêmica, apresentando melhora das lesões. Conclui-se que a reação reversa maculosa deve ser lembrada nos diagnósticos diferenciais com hanseníase recidivada e episódios reacionais clássicos, evitando retratamentos desnecessários.Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo2014-11-30info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionAvaliado pelos paresapplication/pdfhttps://periodicos.saude.sp.gov.br/hansenologia/article/view/3618810.47878/hi.2014.v39.36188Hansenologia Internationalis: leprosy and other infectious diseases; Vol. 39 No. 2 (2014); 70-74Hansenologia Internationalis: hanseníase e outras doenças infecciosas; v. 39 n. 2 (2014); 70-741982-5161reponame:Hansenologia Internationalis (Online)instname:Instituto Lauro de Souza Lima (ILSL)instacron:ILSLporhttps://periodicos.saude.sp.gov.br/hansenologia/article/view/36188/34494https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessRezende, Flávia CuryAbdalla, Beatrice Martinez ZugaibSilveira, Cintia BotelhoAlmeida, Priscilla Guedes Pecoroni deBombonatti, Fernanda FagioliIto, LúciaMachado Filho, Carlos d’Apparecida Santos2023-01-18T17:36:00Zoai:ojs.periodicos.saude.sp.gov.br:article/36188Revistahttps://periodicos.saude.sp.gov.br/hansenologiaPRIhttps://periodicos.saude.sp.gov.br/hansenologia/oaihansen_int@ilsl.br || hansenologia.internationalis@gmail.com || periodicossp@saude.sp.gov.br1982-51610100-3283opendoar:2023-01-18T17:36Hansenologia Internationalis (Online) - Instituto Lauro de Souza Lima (ILSL)false |
dc.title.none.fl_str_mv |
Macular reversal reaction in leprosy: a case report Reação reversa macular da hanseníase: relato de caso |
title |
Macular reversal reaction in leprosy: a case report |
spellingShingle |
Macular reversal reaction in leprosy: a case report Rezende, Flávia Cury Hanseníase Hanseníase Multibacilar Leprosy Multibacillary Leprosy Cellular Immunity |
title_short |
Macular reversal reaction in leprosy: a case report |
title_full |
Macular reversal reaction in leprosy: a case report |
title_fullStr |
Macular reversal reaction in leprosy: a case report |
title_full_unstemmed |
Macular reversal reaction in leprosy: a case report |
title_sort |
Macular reversal reaction in leprosy: a case report |
author |
Rezende, Flávia Cury |
author_facet |
Rezende, Flávia Cury Abdalla, Beatrice Martinez Zugaib Silveira, Cintia Botelho Almeida, Priscilla Guedes Pecoroni de Bombonatti, Fernanda Fagioli Ito, Lúcia Machado Filho, Carlos d’Apparecida Santos |
author_role |
author |
author2 |
Abdalla, Beatrice Martinez Zugaib Silveira, Cintia Botelho Almeida, Priscilla Guedes Pecoroni de Bombonatti, Fernanda Fagioli Ito, Lúcia Machado Filho, Carlos d’Apparecida Santos |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Rezende, Flávia Cury Abdalla, Beatrice Martinez Zugaib Silveira, Cintia Botelho Almeida, Priscilla Guedes Pecoroni de Bombonatti, Fernanda Fagioli Ito, Lúcia Machado Filho, Carlos d’Apparecida Santos |
dc.subject.por.fl_str_mv |
Hanseníase Hanseníase Multibacilar Leprosy Multibacillary Leprosy Cellular Immunity |
topic |
Hanseníase Hanseníase Multibacilar Leprosy Multibacillary Leprosy Cellular Immunity |
description |
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. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-11-30 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Avaliado pelos pares |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://periodicos.saude.sp.gov.br/hansenologia/article/view/36188 10.47878/hi.2014.v39.36188 |
url |
https://periodicos.saude.sp.gov.br/hansenologia/article/view/36188 |
identifier_str_mv |
10.47878/hi.2014.v39.36188 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://periodicos.saude.sp.gov.br/hansenologia/article/view/36188/34494 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo |
publisher.none.fl_str_mv |
Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo |
dc.source.none.fl_str_mv |
Hansenologia Internationalis: leprosy and other infectious diseases; Vol. 39 No. 2 (2014); 70-74 Hansenologia Internationalis: hanseníase e outras doenças infecciosas; v. 39 n. 2 (2014); 70-74 1982-5161 reponame:Hansenologia Internationalis (Online) instname:Instituto Lauro de Souza Lima (ILSL) instacron:ILSL |
instname_str |
Instituto Lauro de Souza Lima (ILSL) |
instacron_str |
ILSL |
institution |
ILSL |
reponame_str |
Hansenologia Internationalis (Online) |
collection |
Hansenologia Internationalis (Online) |
repository.name.fl_str_mv |
Hansenologia Internationalis (Online) - Instituto Lauro de Souza Lima (ILSL) |
repository.mail.fl_str_mv |
hansen_int@ilsl.br || hansenologia.internationalis@gmail.com || periodicossp@saude.sp.gov.br |
_version_ |
1796797580634488832 |