1형 나반응을 동반한 근결핵양나 1례

Abstract

Reactions are acute or subacute hypersensitivity states that complicated the existing active and, more often, the treated infection. A modern description of reactions in Hansen's disease will include 3 types such as Type 1 reaction, erythema nodosum leprosum, and Lucio's phenomenon. Type 1 reaction occurs in patients suffering from borderline leprosy during the first six months of treatment. Characteristic symptoms are nerve pain concomittently with muscle paralysis, rapid swelling & erythema of some or all of the skin lesions and edema of face, hands & feet. It is generally considered that this type of reaction is a delayed hypersesitivity phenomenon in which antigen from breaking down bacilli reacts with T lymphocytes. Our case was sixty five year old woman who had multiple erythematous, swollen lesions on the both hands, feet and face, and suffered from paresthesia, dyshydrosis and mild tenderness on that sites 1 year ago. The symptoms were more aggrevated 20 days ago. General symptoms were accompanied such as fever, malaise, fatigue, loss of appetite. Family and past history was non contributory. And we tried many tests, skin smear and skin biopsy and then concluded final diagnosis was borderline tuberculoid leprosy with type 1 reaction. We had treated this patient with 20-40㎎ of prednisolone, 100㎎ of dapsone, 200㎎ of clofazimine and 600㎎ of rifampicin daily for a week, and then, had transfered to special leprosy clinic in the mild improved state. Now we present a case of borderline tuberculoid leprosy with type 1 reaction with references.