ABSTRACT
BACKGROUND: Hansen's disease or leprosy is a chronic, infectious disease that has locally and globally afflicted all populations. Despite standard treatment with multidrug therapy (WHO-MDT), the incidence of drug resistance has been an increasingly prevalent global problem in leprosy management. This study compared the effectiveness between lymecycline with WHO-MDT and standard WHO-MDT in leprosy treatment. METHODS: The research is a retrospective cohort study at a tertiary hospital from January 2011 to July 2021. Pre- and post-treatment bacillary index, presence of new lesions, nerve function impairment, and leprosy reactions were obtained through chart review. RESULTS: The results showed a significant difference in bacteriological index (BI) in both groups at the end of the treatment. However, a higher reduction in BI was noted for the lymecycline group. For the group that took WHO-MDT alone, BI decreased by 0.7 (P < 0.001) whereas patients who took lymecycline and WHO-MDT had a BI difference of 3 (P < 0.001) upon completion of treatment. A significant decrease in the recurrence of lesions (P = 0.006) and nerve function impairment (P = 0.038) was also noted in the lymecycline group whereas there was no significant difference in leprosy reactions between the two groups. CONCLUSION: Lymecycline 600 mg daily for 3 months can be used as an adjunct in cases of leprosy resistance and treatment failure among multibacillary patients. Lymecycline significantly reduced bacillary index, recurrence of skin lesions, and nerve function impairment through its possible immunomodulatory, antiapoptotic, and neuroprotective effects.
Subject(s)
Leprosy, Multibacillary , Leprosy , Humans , Leprostatic Agents/therapeutic use , Lymecycline/therapeutic use , Drug Therapy, Combination , Retrospective Studies , Leprosy, Multibacillary/drug therapy , Leprosy/drug therapy , World Health OrganizationABSTRACT
Leprosy and tuberculosis are chronic mycobacterial infections that elicit granulomatous inflammation. Both infections are curable, but granulomatous injury to cutaneous structures, including cutaneous nerves in leprosy, may cause permanent damage. Both diseases are major global concerns: tuberculosis for its high prevalence and mortality, and leprosy for its persistent global presence and high rate of neuropathic disability. Cutaneous manifestations of both leprosy and tuberculosis are frequently subtle and challenging in dermatologic practice and often require a careful travel and social history and a high index of suspicion.
Subject(s)
Leprosy, Lepromatous/diagnosis , Leprosy, Tuberculoid/diagnosis , Lupus Vulgaris/diagnosis , Skin/pathology , Antitubercular Agents/therapeutic use , Humans , Leprostatic Agents/therapeutic use , Leprosy/diagnosis , Leprosy/drug therapy , Leprosy, Lepromatous/drug therapy , Leprosy, Tuberculoid/drug therapy , Lupus Vulgaris/drug therapy , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/drug therapy , Tuberculosis, Miliary/diagnosis , Tuberculosis, Miliary/drug therapyABSTRACT
A 40-year-old male presented with multiple erythematous scaly plaques over the right cheek, lips, left preauricular area, 'v' neck areas, the upper extremities, and a large fungating flesh colored tumor on the nasal bridge extending to right eyelid and malar area. Histologically, the plaque lesions were consistent with discoid lupus erythematosus (DLE), and the fungating growth with squamous cell carcinoma (SCC).
