Problèmes actuels en cette période de « post éradication » de la lèpre (Pour les professionnels)

Current Problems in this “Post Eradication Period” of Leprosy (For Professionnals)

*WHO (World Health Organization) has used many techniques to diminish leprosy newly diagnosed cases (to reduce reports of the condition…)

Treatment is said to be easy

• Beliefs and why leprosy is neglected:

1. People and politicians think leprosy does not exist anymore and that it belongs to the past.
2. Teaching in medical school and specilists in dermatology is virtually inexistent
3. WHO policies favour researchers to study other conditions such as AIDS
4. Dermatologists care more about “cosmetics” than the poor
5. Dermatology does not have a community aspect
6. Neurologists do not care at all

WHO recommends 3 months of treatment for type I reactions when more are necessary !

• Presenter’s recommendation:

1. Borderline Tuberculous: 3-6 months of treatment
2. Borderline:6-9 months
3. Borderline Lepromatouis: 6-24 months

• Concerning nerve reversal reaction: the who recommends 3 months of treatment but 6 are necessary. The problem is that after 3 months of treatment, the patient feels no more nerve symptoms when in fact there is silent nerve damage

WHO mentions that after 1 month ENL (Erythema Nodosum Leprosum) improves but that steroid dependency can be a problem !

• Data shows that:

1. in 25% of patients, duration is one week
2. in 50% of patients, duration is 2 weeks
3. in over 90%, duration is less than 1 month

• Many treatments are said to be effctive when  in fact it is spontaneous resolution

*Opinions of the presenter do not necessarily represent those  of the Global Dermatology Information Portal

Naafs B, Leprosy – 22nd World Congress of Dermatology (WCD) – Seoul, South Korea