Lepra Reactions: A Retrospective Clinical Study

Introduction: Lepra reactions are common immunologically mediated phenomena in the course of Hansen's disease. They are characterized by inflammation affecting skin, nerves, mucous membranes and/ other sites. Lepra reactions are of 2 types - Type 1 and Type 2. Aims: To study the clinical patterns of Lepra reactions at a tertiary care hospital of Assam during the period of 1 year from September 2018 - August 2019. Materials and Methods: This is a Retrospective, hospital based study in patients of Hansen's disease with Lepra reactions attending a tertiary care hospital of Assam. Results : A total of 87 patients with Hansen's disease attended the OPD during the study period, out of which 38 (43.6%) patients presented with lepra reactions. 71% were males (n=27) and 29% were females (n=11). Most patients presented in their 3rd decade. Type 2 lepra reactions (n= 21; 55%) were more than Type1 (n=17; 45%). Majority of patients (n=25; 66%) developed lepra reactions after initiation of MDT therapy, while (n=13; 34%) developed lepra reactions before initiation of MDT therapy. Type1 lepra reactions were more commonly seen with BT leprosy. Patients presented mostly with tender erythematous skin lesions along with neuritis, while only a few presented with neuritis only. Type 2 was more common with LL leprosy and most patients presented with ENL lesions while 2 patients had ENN lesions. WHO grades of deformity was seen in 73% patients. Conclusion: Lepra reactions constitute a significant proportion among hansen?s disease patient. Type 2 lepra reactions were more common than type 1 lepra reaction. Lepra reactions should be treated promptly and adequately due to the risk of developing deformities and disabilities.