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What is Lepra reaction?

Written by Dr Sunder Rao Bethapudy
Category: FAQs

This particular condition of leprosy is not commonly described except among the medical staff, hence it is least known among the public. Yet, it is one of the most dreadful conditions the leprosy patients undergo, if not properly managed the leprosy in their body can get worst and present more complications. As a matter of fact it is not well understood even by the medical staff and hence management can be difficult.


So, what is Lepra reaction?


In simple terms, it is an abrupt change in immunological response of the body to the lepra bacteria. Because the leprosy affects mainly the skin and the nerves of the body, this lepra reaction affects mainly the skin, the nerves although other parts like joints are affected.


Severity of the reaction depends on :


1) amount of bacterial load


2) Strength of immunological reaction.

Clinically, this reaction presents with pyrexia, pain all over the body, already existing patches may get worst and new patches may appear, generally miserable feeling, pain and swelling the joints, severe neuritis ( pain along the nerves) and eye complications.

How often these reactions occur among the Leprosy patients?

In milder cases about 20% and in severe cases about 40%


When does this condition present?

Not all patients get it but it may present

a) in the beginning of the treatment

b) During treatment or

c) After completion of the treatment.

Patients with lepra reaction are at higher risk of developing deformities than those who do not have this reaction. That includes eye complications.


Generally 70% of the leprosy patient has eye complications.


Who are at risk of getting Lepra Reaction among the Leprosy patients?

There are few types of Leprosy although the disease is caused by one bacterium. Two polar types called Lepramatous Leprosy (where there is no resistance by the body to the bacteria for its spread in the body) and Tuberculoid (Where there is a lot resistance by the body) and in the middle is the Borderline type of Leprosy (Immunologically speaking).


1) Those who present with Borderline type of Leprosy

2) Where there are patches close to the nerves

3) Patches on the face

4) Patients with nerve thickening

5) Infections, infestations and vaccinations


Finally, hormonal changes a) during puberty b) pregnancy and c) childbirth. There are two types of Lepra Reaction

1) mild reaction

2) Severe reaction.


It is the severe reaction that needs a lot of attention. Usually they need admission into the hospital.

1) Rest

2) Pain killers

3) Splints to the joints

4) Minor surgery for the abscesses

5) Main drug used is Steroids

6) counselling

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