MyMedR

The Function of HLA-B*13:01 Involved in the Pathomechanism of Dapsone-Induced Severe Cutaneous Adverse Reactions

Chen WT, Wang CW, Lu CW, Chen CB, Lee HE, Hung SI, et al.

J Invest Dermatol, 2018 07;138(7):1546-1554.

PMID: 29458119 DOI: 10.1016/j.jid.2018.02.004

Dapsone-induced hypersensitivity reactions may cause severe cutaneous adverse reactions, such as drug reaction with eosinophilia and systemic symptoms (DRESS). It has been reported that HLA-B*13:01 is strongly associated with dapsone-induced hypersensitivity reactions among leprosy patients. However, the phenotype specificity and detailed immune mechanism of HLA-B*13:01 remain unclear. We investigated the genetic predisposition, HLA-B*13:01 function, and cytotoxic T cells involved in the pathogenesis of dapsone-induced severe cutaneous adverse reactions. We enrolled patients from Taiwan and Malaysia with DRESS and maculopapular eruption with chronic inflammatory dermatoses. Our results showed that the HLA-B*13:01 allele was present in 85.7% (6/7) of patients with dapsone DRESS (odds ratio = 49.64, 95% confidence interval = 5.89-418.13; corrected P = 2.92 × 10-4) but in only 10.8% (73/677) of general population control individuals in Taiwan. The level of granulysin, the severe cutaneous adverse reaction-specific cytotoxic protein released from cytotoxic T cells, was increased in both the plasma of DRESS patients (36.14 ± 9.02 ng/ml, P < 0.05) and in vitro lymphocyte activation test (71.4%, 5/7 patients) compared with healthy control individuals. Furthermore, dapsone-specific cytotoxic T cells were significantly activated when co-cultured with HLA-B*13:01-expressing antigen presenting cells in the presence of dapsone (3.9-fold increase, compared with cells with no HLA-B*13:01 expression; P < 0.01). This study indicates that HLA-B*13:01 is strongly associated with dapsone DRESS and describes a functional role for the HLA-restricted immune mechanism induced by dapsone.

Matched MeSH terms: Leprosy/drug therapy*

Fulltext Isolated Bilateral Pinna Swelling: A Rare Initial Presentation of Leprosy

Yusuf SYM, Ismail IA, Hamid RA, Jamil NA, Yasin MM

Open Access Maced J Med Sci, 2019 Jun 15;7(11):1815-1817.

PMID: 31316665 DOI: 10.3889/oamjms.2019.481

BACKGROUND: Leprosy or Hansen disease is a chronic infectious disease that causes social stigma due to its deforming bodily appearance and physical disability. It has a wide spectrum of presentation affecting diagnosis.

CASE REPORT: A 21-year-old man who presented with chronic isolated bilateral pinna swelling as a result of leprosy is reported. The bilateral pinna swelling started as multiple shiny papules with an erythematous background and progressively became hyperpigmented and lobular over two years. This rare presentation of leprosy poses initial diagnostic difficulties, leading to misdiagnoses by various health care professionals. Diagnoses ascribed include eczema, insect bite and perichondritis. A suspicion of leprosy was raised when hyperaesthetic hypopigmentation of skin started to appear on the body after two years, with worsening of the pinna swellings. This was confirmed by identification of Mycobacterium leprae in slit skin smear test and skin biopsy.

CONCLUSION: Isolated involvement of pinna in a patient without lesions in other body parts is an unusual initial presentation of leprosy. However, leprosy should be kept as a rare differential diagnosis of isolated lesions on the ear in patients not responding to conventional treatment.

Matched MeSH terms: Leprosy

Pattern of skin diseases among patients attending an outpatient dermatology clinic in a tertiary hospital in urban Malaysia

Kwan Z, Wong SM, Robinson S, Tan LL, Ismail R

Australas J Dermatol, 2017 Nov;58(4):e267-e268.

PMID: 28660702 DOI: 10.1111/ajd.12541

Matched MeSH terms: Leprosy/epidemiology

Fulltext Some experiences with non-traumatic paraplegia in Malaysia

Silva JF

Paraplegia, 1973 Aug;11(2):146-58.

PMID: 4584434 DOI: 10.1038/sc.1973.19

One hundred and forty-one patients with non-traumatic paraplegia were reviewed. The common causative factors and the problems arising were evaluated. Management of the clinical problems were described. The need for prevention and early treatment has been stressed.

Matched MeSH terms: Leprosy/complications

Fulltext Facial lesions resembling leprosy

Mohamed KB

Int. J. Lepr. Other Mycobact. Dis., 2001 Mar;69(1):35-7.

PMID: 11480315

Matched MeSH terms: Leprosy/diagnosis*

Fulltext Studies on sulfone resistance in leprosy. 3. A case of "partial" resistance

Pearson JMH, Pettit JHS, Rees RJ

Int. J. Lepr. Other Mycobact. Dis., 1968;36(2):171-8.

PMID: 4877115

Proof that a patient is suffering from sulfone-resistant leprosy depends on demonstrating that his bacilli can multiply in the mouse foot pad even when the mice are fed sulfone in the diet. Hitherto the maximal dose of DDS tolerated by the mouse has been used in such tests. This paper concerns a patient whose bacilli multiplied in mice fed lower doses of DDS, but were inhibited when the maximal dose was used . His clinical features are distinctive and probably characteristic of this type of "partial" resistance. It is likely that more cases of this type will be found . Recommendations are made concerning the investigation of possible DDS-resistant leprosy patients and their treatment.

Matched MeSH terms: Leprosy/drug therapy*

Fulltext Medical services to the aborigines in West Malaysia

Bolton JM

Br Med J, 1968 Jun 29;2(5608):818-23.

PMID: 5658921

Matched MeSH terms: Leprosy/prevention & control

A preliminary note on the treatment of ulcers with shark liver oil

Velupillay M

Journal of the Malaya Branch of the British Medical Association, 1941;5:34-40.

Matched MeSH terms: Leprosy

Fulltext A Scoping review of the effectiveness of control interventions of human and Canine Rabies in an effort to Rationalise the One Health Approach

Nur Asheila Abdul Taib, Razitasham Safii

Borneo Epidemiology Journal, 2020;1(1):16-34.

MyJurnal

According to the World Health Organization (WHO), rabies is one of the 18 neglected tropical diseases, together with dengue, leprosy, and trachoma, among others. Despite being a vaccine-preventable disease, the latest estimate of annual human rabies mortality from a 2015 study is as high as 59,000 throughout 150 countries. In human rabies, more than 95% of the cases are due to dog bites, making the elimination of canine rabies a global priority by fighting the disease at its animal source. World Health Organization (WHO), World Organization for Animal Health (OIE), Food and Agriculture Organization (FAO) of the United Nations, and the Global Alliance for Rabies Control (GARC) have warranted the One Health framework with the objective of complete eradication of dog-related human rabies by the year 2030. In an effort to rationalise the One Health approach, this scoping review found 17 studies on assessing the effectiveness of control interventions of human and canine rabies. Different strategies were implemented based on the endemicity of rabies in a particular country. Overall, the combined strategies using the One Health approach, which allows effectiveparticipation and communication between different agencies, have shown promising results in reducing rabies cases. These strategies will hopefully realise the goal in the Global Strategic Plan to achieve zero canine-mediated human rabies death by the year2030.

Matched MeSH terms: Leprosy

Fulltext The mystery of 'saturation gap': a case of dapsone-induced methaemoglobinemia in a pregnant mother with leprosy

Tang ASO, Yeo ST, Teh YC, Kho WM, Chew LP, Muniandy P

Oxf Med Case Reports, 2019 Jan;2019(1):omy111.

PMID: 30697428 DOI: 10.1093/omcr/omy111

Limited data regarding methemoglobinemia in pregnancy, particularly secondary to dapsone is available up to date. We report a case of dapsone-induced methemoglobinemia in a pregnant mother with multibacillary leprosy who presented with fever, productive cough and cyanosis of 2 days duration 2 weeks after multidrug therapy was commenced. On examination, she had central cyanosis with low oxygen saturation (SpO2 = 84-88%). Arterial blood gas analysis showed PO2 of 111 mmHg and SO2 of 98 mmHg. Patient was administered 100% oxygen inhalation, but there was no improvement in cyanosis. Vitamin C (1000 mg/day) was prescribed. Dapsone was replaced by ofloxacin 200 mg twice daily. There was a gradual increase in SpO2 level. She delivered a healthy baby. In conclusion, clinicians should be aware of the side effects of dapsone and know how to promptly manage any undesirable events. Ofloxacin is a safe and feasible alternative in replacement of dapsone in pregnancy.

Matched MeSH terms: Leprosy, Multibacillary

Fulltext Primary dapsone resistant Mycobacterium leprae in a non endemic country

Jamil A, Noor NM, Osman AS, Baseri MM, Muthupalaniappen L

Indian J Dermatol Venereol Leprol, 2013 Jul-Aug;79(4):527-9.

PMID: 23760326 DOI: 10.4103/0378-6323.113096

Matched MeSH terms: Leprosy/drug therapy*; Leprosy/epidemiology*

Fulltext Leprotic iritis and blindness

Hobbs HE

Int. J. Lepr. Other Mycobact. Dis., 1972;40(4):366-74.

PMID: 4677492

Matched MeSH terms: Leprosy/complications*; Leprosy/therapy

Hydnocarpus: an ethnopharmacological, phytochemical and pharmacological review

Sahoo MR, Dhanabal SP, Jadhav AN, Reddy V, Muguli G, Babu UV, et al.

J Ethnopharmacol, 2014 May 28;154(1):17-25.

PMID: 24732111 DOI: 10.1016/j.jep.2014.03.029

The genus Hydnocarpus (Flacourtiaceae) includes forty species that are spread across the globe. In the Indian System of Medicine, Hydnocarpus pentandrus (Buch.-Ham.) Oken. is primarily used for treating leprosy and other skin disorders. It is known as "Chaulmoogra" and is also used to treat other indications including constipation, inflammation, blood disorders, and worm infestations. Various species of Hydnocarpus are also used in traditional medicine in China, Thailand, Malaysia, and Myanmar for several skin disorders. To assess the therapeutic potential of species from the Hydnocarpus genus and to determine future avenues for research.

Matched MeSH terms: Leprosy/drug therapy

Fulltext Anterior leprotic retinitis of trantas: a case report

Singh M

Med J Malaysia, 1985 Jun;40(2):139-41.

PMID: 3841732

A case of rare retinal lesion occurring in a young girl suffering from lepromatous leprosy is described. Fundus lesions in leprosy are extremely rare but do occur in some cases without causing any threat to vision. Their response to antileprotic treatment is not clearly known.

Matched MeSH terms: Leprosy/complications*

Hypersensitivity reaction to dapsone: report from Malaysia

Mohamed KN

Lepr Rev, 1984 Dec;55(4):385-9.

PMID: 6527602

Matched MeSH terms: Leprosy/drug therapy*

Fulltext Unusual reaction to intramuscular sulfone in two leprosy patients in Malaysia

Laing ABG

Int. J. Lepr. Other Mycobact. Dis., 1980 Mar;48(1):70.

PMID: 7189187

Matched MeSH terms: Leprosy/drug therapy*

Fulltext Histopathology of skin lesions in leprosy