Carole - herxing in leprosy

[Guest guest]

" There can be no doubt that erythema nodosum leprosum [a specific new

lesion pattern seen in lepromatous leprosy] is a consequence of

effective chemotherapy and consequent killing of M leprae. "

Sayeth Godal and Levy in " The mycobacteria: a sourcebook, " eds Kubica

and Wayne.

Tho the succeeding paragraph does not literally squelch all doubt, it

provides some reasoning/observations.

The borderline or reversal reactions (seen in borderline leprosy) are

also induced by treatment, inter alia, according to the same book

chapter. Interestingly, these are seen in conjunction with a shift of

immunologic parameters toward those of tuberculoid leprosy. This

suggests that upregulation of specific immunity against M leprae may

be at play, tho TLR ligation might figure here as well.

How common these reactions are, I dont know. They may not occur in

the majority of cases.