Therapeutic Options for the Reactional States of Leprosy

Abstract

Introduction: The reactional states of leprosy are episodes of sudden increase in clinical activity that occur during the evolution of the disease over time, as a consequence of losing the balance maintained between the mycobacterium and the patient's immune system. In this period, there are hypersensitivity responses that interrupt the chronic course of the disease, and acute inflammation manifests, which are the main cause of nerve lesions and disabilities in leprosy.

Objective: To update the information about the treatments indicated in the reactional states of leprosy.

Methods: A bibliographic review was carried out with the articles on the topic available in SciELO, the WHO, the PAHO, VHL-Cuba, PubMed Central, Medline and Medigraphic. The descriptors used were lepra [leprosy] and tratamiento [managment]. Seven books and ten articles were cited, 71 % of which were published within the last five years.

For the management of reactional states, analgesic, antiinflammatory and immunosuppressive drugs, among others, are available. The type of reactional state and its severity define the therapeutic scale to be used. In mild cases, analgesics and nonpharmacological measures such as rest will be used. Glucocorticoids are the mainstay in the initial management of severe forms of lepra reaction.

Conclusions: Correct management of leprosy and early identification of reactional states prevent neurological damage and disabilities produced by this entity. Corticosteroids continue to be the first line of treatment for leprosy reactions.