Macular reversal reaction in leprosy: a case report

Detalhes bibliográficos
Autor(a) principal: Rezende, Flávia Cury
Data de Publicação: 2014
Outros Autores: Abdalla, Beatrice Martinez Zugaib, Silveira, Cintia Botelho, Almeida, Priscilla Guedes Pecoroni de, Bombonatti, Fernanda Fagioli, Ito, Lúcia, Machado Filho, Carlos d’Apparecida Santos
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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spelling 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
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