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Retreatment of leprosy relapse

BACKGROUND: Studies concerning re-treated leprosy patients are justified by thedifficulty in differential diagnosis between a reactional state following the end of a specific treatment for leprosy and its relapse, owing to limitations in clinical and laboratorial criteria to distinguish them. OBJECTIVES: To verify diagnostic procedures (clinical and laboratorial) that subsidized relapse treatment and occurrence of reactional episodes, in particular those that occurred after treatment completion. METHODS: A hundred fifty-five leprosy patients retreated for relapse in two leprosy reference units in the municipality of Recife/PE, Brazil, in a retrospective case series study. RESULTS: Clinical criterion was the most used to decide for re-treatment of relapse, and new described lesions were mainly of macular and infiltrative type. Reactional episodes after discharge occurred in 34% of these patients, and 33.9% related the presence of contacts with hansenasis. Only 14.9% of the 155 studied patients had histological examinations performed, and 18.1% did not have bacilloscopy carried out before re-initiating specific therapy. CONCLUSION: This study has shown that post-treatment reactional episodes and presence of contacts with leprosy occurred in about 30% of patients who were re-treated for relapse and that further controlled studies are necessary for a better understanding of these factors.

Hypersensitive; Leprosy; Recurrence; Retreatment


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