Type 1 lepra reaction in Adult
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Synopsis
Type 1 reactions are due to changes in cell-mediated immunity (CMI) to the infectious agent Mycobacterium leprae. Type 1 reactions may occur in any subtype of leprosy, but patients with borderline leprosy are most frequently affected. Patients present with increased erythema, edema, and warmth of preexisting cutaneous plaques and nodules. There is often accompanying edema of the hands and feet. New ulcerations of preexisting lesions may also occur, as well as the formation of new plaques. Additionally, there may be swelling and tenderness of peripheral nerves and loss of neurologic function. Systemic symptoms are uncommon. This reaction may be seen after pregnancy or immunosuppressive treatment. It may also occur in patients co-infected with human immunodeficiency virus (HIV) within months of starting antiretroviral therapy.
Prompt diagnosis and treatment of lepra reactions is necessary to prevent significant neurologic morbidity and disability.
Codes
ICD10CM:B92 – Sequelae of leprosy
SNOMEDCT:
240407009 – Type 1 lepra reaction
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Differential Diagnosis & Pitfalls
- Sweet syndrome
- Rheumatoid neutrophilic dermatosis
- Granuloma annulare
- Tinea infection
- Urticaria
- Urticarial vasculitis
- Annular psoriasis
- Cutaneous leishmaniasis – In endemic regions. (See Old World and New World leishmaniasis.)
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Last Reviewed:08/31/2017
Last Updated:08/31/2017
Last Updated:08/31/2017
Type 1 lepra reaction in Adult