REACTIONS
・ Apart from the 'routine', commonly occurring forms of leprosy illustrated in pictures 1-23 (see 1. Paucibacillary (PB) Leprosy Cases), frontline health workers and volunteers should be able to recognise and refer patients in reaction.
・ Reactions in leprosy occur when the immune system, for reasons which are essentially unknown, reacts against the bacillary infertion.
・ Far from being helpful or protective, these reactions are often damaging to skin, nerves and other tissues.
・ Skin lesions become swollen, hot, red and painful. Ulceration may occur.
・ More importantly, nerves are also inflamed and swollen and this may result in damage to nerve fibres carrying messages for sensation and muscle power.
・ In some cases, such damage may occur suddenly, either at the time of diagnosis or, during treatment, or after treatment has finished.
・ The following pictures are included to help frontline health workers and volunteers to recognise reactions and refer the patient for expert advice.
・ Inthe following pages, reactions are classified into Type 1 (Reversal or upgrading) + Type 2 (Lepromatous or ENL).
