Medhi Denisa Alinda
Department Of Dermatology And Venereology, Faculty Of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Teaching Hospital, Surabaya

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Diagnosis and Management of Leprosy Medhi Denisa Alinda; Silvani Geani; Regitta Indira Agusni; Bagus Haryo Kusumaputra; Novianti Rizky Reza; Cita Rosita Sigit Prakoeswa; Muhammad Yulianto Listiawan
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 32 No. 2 (2020): AUGUST
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V32.2.2020.149-157

Abstract

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which tends to attack peripheral nerves and skin. The diagnosis of leprosy is based on the presence of one of three cardinal signs. Early diagnosis of leprosy is critical and is made through clinical examination and investigation. Purpose: To discuss the diagnosis, laboratory examination, and treatment of leprosy, considering that early diagnosis and appropriate treatment are the key elements in breaking the chain of transmission and preventing leprosy patients' disabilities. Review: Leprosy is a chronic granulomatous infectious disease caused by the Mycobacterium leprae. Based on clinical appearance, histopathology findings, and immunological, leprosy is grouped into six forms using the Ridley-Jopling classification, namely Tuberculoid (TT), Borderline Tuberculoid (BT), Borderline-borderline Mid-borderline (BB), Borderline-lepromatous (BL), Subpolar Lepromatous (LLs), and Polar Lepromatous (LLp). Based on the treatment category, leprosy is grouped into paucibacillary (PB) and multibacillary (MB). Leprosy is often diagnosed clinically, and skin scraping smear remains the preferred laboratory method. The negative results of smear skin scraping may not necessarily exclude leprosy. Therefore, a higher sensitivity test might be needed to detect M. leprae. Treatment with Multi-Drug Therapy (MDT) is adjusted based on the type of leprosy, whether it belongs to the PB or MB group. Treatment of PB type, regimens are rifampicin and dapsone, while in MB type, the patients received rifampicin, dapsone, and clofazimine regimens. Conclusion: A proper diagnosis for leprosy, both through physical examination and laboratory examination, is required to determine an effective MDT treatment and break the chain of disease transmission.
A Retrospective Study: Epidemiology, Onset, and Duration of Erythema Nodosum Leprosum in Surabaya, Indonesia Cindy Fransisca; Iskandar Zulkarnain; Evy Ervianti; Damayanti Damayanti; Maylita Sari; Budiono Budiono; Medhi Denisa Alinda; Bagus Haryo Kusumaputra; Muhammad Yulianto Listiawan
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 1 (2021): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.1.2021.8-12

Abstract

Background: Erythema nodosum leprosum (ENL) has a chronic and recurrent nature which could reduce patient’s quality of life in addition to the onset of ENL that occurs before, during, or after multidrug treatment, further emphasizing the importance of regular control and education.Purpose:This study aimed to evaluate the epidemiology, onset, duration, and recurrence of ENL. Methods:Data from medical records were obtained for a 3-year retrospective study of multibacillary leprosy patients at the Leprosy Division of the Dermatology and Venereology Outpatient Department, Dr. Soetomo General Hospital Surabaya, with a minimum of 2–5 years follow-up period.Result:The prevalence of  ENL continued to increase almost every year especially in 2017 (32% in 2015; 32% in 2016; and 36% in 2017). ENL most often occurs during the first year of multi-drug therapy (MDT) administration followed by after the release from treatment (RFT) with the latest onset occurring 4 years after RFT. The majority of patients experienced chronic and recurrent reactions with the longest reactions lasting up to 4.5 years (55 months). Conclusion:Knowledge about the onset, duration, and recurrences of ENL are essential, and strict supervision for routine control shall be encouraged to increase the patients’ compliance so as to increase their quality of life.