Seventy-seven patients who were treated regularly for more than 5 years in the Taegu Leprosy Mission were investigated with regard to the change of the bacillary index(BI) after treatment of either dapsone(DDS) alone or a combination of DDS and clofazimine. The results were as follows: 1) In the group that took only DDS 400-500 mg per week, the BI conversion to negative took average 51 months. 2) In the group that took only 600-700 mg per week, the BI conversion to negative took average 34 months. 3) In the group that took only DDS 400 mg per week initially and 600-700mg per week secondarily, the BI conversion to negative took average 64 months, the last 33 months of which marked the time period that 600-700 mg were taken per week. 4) In the group that took only DDS 400-500mg per week initially and a combination of DDS gpp 700 mg per week and clofazimine. 3pp-4pp mg per week secondarily, the BI conversion to negative took average 63 months, the last 35 months of which marked the time period for the combined therapy. 5) In the group that took a combination of DDS 600- 700 mg per week and clofazimine 400 mg per week, the BI conversion to negative took average 42 months.
Clofazimine* ; Daegu ; Dapsone* ; Humans ; Leprosy* ; Missions and Missionaries

Melkersson-Rosenthal syndrome(MRS) is a rare neuro-muco-cutaneous disease of unknown origin. The classic triad of this clinically defined entity consists of orofacial swelling, facial nerve palsy, and lingua plitica. MRS may occur as a complete triad of symptoms or a combination of any features of the classic triad, termed monosymptomatic and oligosymptomatic forms. The complete triad has been reported to occur in only 10% to 20% in different series. Because of the rarity of reported cases in Korea, we report a case of complete form of MRS, in which clofazimine showed a partial response.
Clofazimine ; Facial Nerve ; Korea ; Melkersson-Rosenthal Syndrome* ; Paralysis

While for the last thirty years Dapsone (4,4, diaminodiphenyl sulfone; DDS) has been the chemotherapeutic treatment of choice in the management of leprosy, other non-sulfone compounds have been used when patients have shown either sulfone resistance or sulfone sensitivity. Unfortunately, however, there have gradually appeared a significant number of dapsone resistant and non-sulfone resistant patients (i. e., patients resistant to the conventional chemotherapeutic management of leprosy), thus necessitating the synthesis of additional antileprotic medication. At present, it appears that Lamprene (Clofazimine) is the most adequate preparation for the treatment of sulfone and/or other anti-leprotic drug resistant cases, as well as reactive states. The work of Browne and Hogerzeil in 1962, and subsequent studies by ether workers, have demonstrated lamprenes anti-leprotic and anti-inflamatory effects. The drug has also been need successfully in the management of the reactive patient. However, as its most untoward side effect, the drug causes an unsightly darkening of the skin in those areas where the concentration of M. leprae is greatest. Because the literature provides only sparse data on the effect of lamprene on the morphological (MI) and bacteriological (BI) indices of bacteriologically open patients, the authors undertook the following study: Eighteen dapsone resistant patients, two of whom were in lepra, reaction, received a daily dose of 100mg. of lamprene during a period. ranging from 4 to 22 months. Patients were kept under close clinical observation and bacteriological samples were taken at an average of three month intervals from eight different sites on the body, All subjects were in residence at the National Leprosy Hospital of Korea on Sorok island. The study yielded the following results: 1) Within 3 to 8 months after the administration of lamprene, the MI decreas d to the base line in all patients save one. 2) In the short term administered group (less than 10 months), 6 of 1R patients showed a BI increase in inverse proportion to an MI decrease during the initial stage of lamprene administration. However, the BI began to decrease between the 4th and 5th months of treatment. Of the remaining 7 patients, all showed a decrease in both BI and MI. 8) In the long term administered group (more than 10 months), the BI, an indicat- or in the evaluation of long term administration, gradually decreased in 4 of 5 patients. In the remaining patients the BI increased. The authors regard the inverse relationship between the BI and MI as the result of the increment of bacilli secondary to the destruction of M. leprae by lamprene. That groups showed a decrease in both BI and Ml is interpreted as lamprenes biochemical intervention so as to render M. leprae more susceptible to phagocytosis. While. no ready explanation can account for the single case in which the BI increased and the MI also increased, the pos. ibility that there might be a strain of M. leprae resistant to lamprene must be ruled out. thus, given the above results, the authors conclude that lamprene is a valuable antileprotic drug not only for DDF>resistant patients but also for patients in lepra reaction. Moreover, this drug seems to find its best setting in the leprosarium where the untoward side effect of darkened skin does not in any way diminish the patients social relationships.
Clofazimine* ; Dapsone* ; Ether ; Humans ; Korea ; Leprosy ; Leprosy, Lepromatous* ; Phagocytosis ; Skin

Clofazimine (Lamprene or B668) is a phenazine congener that is used in leprosy, and the patients treated with the drug may develop red discoloration, dark brown pigmentation and ichthyotic skin. The authors observed 181 leprosy patients who had developecl discoloration, pigmentation and ichthyotic skin during clofazimine therapy, as well as disappearance of the pigmentation after stop of it. The results are summarized as follows: 1) Reddish discoloration was most frequently observed 2 weeks after beginning treatment in 66 patients (50. 4%), which showed earlier in the higher dosage grow up, 2) Dark brown pigmentation was iviost frequently observed 4 weeks after beginning treatment in 64 patients (48. 9%), which showed earlier in the higher dosage group. R) For histopathological evaluation of pigmentation, various ataining rnethods were used. On unstained frozen sections, yellow brown crystals were scattered in the dermis of both discolored and pigmented skin, and in H R E stain pigments, melanin were niarkedly increased in the epidermal basal layer and a, faint yellow brown. ghost was seen in dermis of pigmented skin. With fat stains using oil-red-0 and Sudan III, reddish amorphous materials were scattered in and around the cytoplasm of the macrophages c>f the pigmented skin. 4) Ichthyotic skin was observed in 97 patients, and most frequently 2 and R months after beginning treatment in 26 patients (26. 8%), but it was never observec1 in 34 of all patients in spite of a continuous intake of the drug for more than a. year. -countinue-
Clofazimine* ; Coloring Agents ; Cytoplasm ; Dermis ; Frozen Sections ; Humans ; Leprosy* ; Macrophages ; Melanins ; Pigmentation ; Skin ; Sudan

We present herein a case of pyodcrma gangrenosum, who showed good response to clofazimine therapy. The patient, 19-year-old male, had suffered from chronic diarrhea for 10 months before the rapidly spreading pustules and ulcers with undermined purple-to-red borders devkloped on his both lower and upper extremitics. Clofazimine was given orally in a dose of 100mg three times daily for 16 days, and tapered to 100 mg two times daily for the next 11 days. Clinical improvement was noted after 7 day's treatment and the almost all of the skin lesiors were replaced by granulation tissue with epithelizatiori or crust formation after 6 days treatment.
Clofazimine* ; Diarrhea ; Granulation Tissue ; Humans ; Male ; Pyoderma Gangrenosum* ; Pyoderma* ; Skin ; Ulcer ; Young Adult

The Clofazimine is a rimino-phenazine dye. The color is a purplish-back. The drug is reported to be weakly bactericidal and also effective in the management of leprosy reactions apparently. The drug produces relatively few side effects in the majority of patients. The most prominent is coloration of the skin. The coloration can range anywhere from a reddish-tan to purplish-black. so, many patients avoid taking clofazimine. The Q-switched ND-YAG laser is a good medical instrument for clearing coloration of the skin. It releases two wavelength of 532nm and 1064nm. The wavelength of 532nm reachs shallow depth of the skin. So, it is effective in the clearance of a red, yellow tatto, freckle and lentigo. The wavelength of 1064nm reachs about 4-6mm depth of the skin. So, it is effective in the clearance of blue-black tatto and ota nevus. The leprosy patients who has purplish-black coloration of the skin in the face due to clofazimine is cleared by Q-switched ND-YAG laser. We operated twice with 3months interval. The wavelength is 532nm, spot size 3mm, energy 1.5J/cm2. The coloration of the skin in the face is almost cleared.
Clofazimine* ; Humans ; Lasers, Solid-State* ; Lentigo ; Leprosy ; Melanosis ; Nevus of Ota ; Skin*

Chemotherapy is a main component of treatments for leprosy. The World Health Organization (WHO) recommends multiple-drug therapy (MDT) consisting of dapsone, clofazimine and monthly rifampin as the first-line drugs against leprosy. Minocycline, clarithromycin and certain fluoroquinolones can be used as substitutes in dapsone or clofazimine. For management of reactions, type I reactions should be treated with corticosteroids while thalidomide is the drug of choice for type II reaction. This review summarizes pharmacologic effects of drugs being used in leprosy including mechanisms of action, side effects, drug interactions and drug resistance.
Adrenal Cortex Hormones ; Clarithromycin ; Clofazimine ; Dapsone ; Drug Interactions ; Drug Resistance ; Drug Therapy ; Fluoroquinolones ; Leprosy* ; Minocycline ; Rifampin ; Thalidomide ; World Health Organization

Despite global efforts to control tuberculosis (TB), multidrug-resistant TB (MDR-TB) is still a serious problem worldwide. The diagnosis of MDR-TB is based on mycobacterial culture followed by drug susceptibility testing, with results available in weeks to months. This requirement calls for rapid direct tests, especially genotypic tests, in which specimens are amplified directly for the detection of MDR-TB. The treatment of MDR-TB is challenging because of the high toxicity of second-line drugs and the longer treatment duration required compared to drug-susceptible TB. The selection of drugs in MDR-TB is based on the treatment history, drug susceptibility results, and TB drug resistance patterns in each region. Recent World Health Organization guidelines recommend the use of at least four second-line drugs (i.e., a newer fluoroquinolone, an injectable agent, prothionamide, and cycloserine or para-aminosalicylic acid) in addition to pyrazinamide. Kanamycin is the initial choice of an injectable drug, and newer fluoroquinolones include levofloxacin and moxifloxacin. For extensively drug-resistant TB, group 5 drugs such as linezolid and clofazimine need to be included. New drugs such as delamanid and bedaquiline have recently been approved for treating MDR-TB and other agents with novel mechanisms of action that can be given for shorter durations (6-12 months) for MDR-TB are under investigation.
Clofazimine ; Cycloserine ; Diagnosis* ; Drug Resistance ; Fluoroquinolones ; Kanamycin ; Levofloxacin ; Prothionamide ; Pyrazinamide ; Tuberculosis ; Tuberculosis, Multidrug-Resistant* ; World Health Organization

Mycobacterium abscessus is the second most important pathogen in pulmonary disease caused by nontuberculous mycobacteria (NTM), following Mycobacterium avium. Mycobacterium abscessus is classified into three subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii. Mycobacterium abscessus is the most difficult to treat NTM due to its resistance to many antibiotics. Treatment should include an initial regimen of 2–3 injectable and oral antibiotics for several weeks or months, followed by inhaled amikacin and 1–3 oral antibiotics, depending on the subspecies and drug susceptibility patterns, including macrolide susceptibility. The continuation phase should be continued for a minimum of 12 months after culture conversion. Suitable injectable antibiotics include amikacin, imipenem, cefoxitin, and tigecycline, while oral antibiotics include macrolides (azithromycin or clarithromycin), clofazimine, linezolid, and moxifloxacin. Surgery can be a useful adjunctive therapy for some patients with refractory disease. However, the overall treatment prognosis is still unsatisfactory. Therefore, novel and more effective interventions are required for the treatment of M. abscessus pulmonary disease.
Amikacin ; Anti-Bacterial Agents ; Cefoxitin ; Clofazimine ; Humans ; Imipenem ; Linezolid ; Lung Diseases ; Macrolides ; Mycobacterium avium ; Mycobacterium ; Nontuberculous Mycobacteria ; Prognosis

Sweet's syndrome, first described in 1964 by Sweet, is characterized by fever, neutrophilic leukocytosis, sudden onset of asymmetric, erythematous, often painful skin lesions, and dense dermal infiltrates of mature neutrophils without signs of vasculitis. The disease responds rapidly to systemic therapy with corticosteroids but recurs in about 25% of the cases. Alternative treatments include potassium iodide, colchine, dapsone, clofazimine, cyclosporin. We report a case of classic sweet's syndrome which was successfully treated with potassium iodide without adverse reactions. 33 year-old male patient became afebrile and symptom free within 24h after starting potassium iodide 900mg/day. The cutaneous eruptions subsided completely in 5 days. He received the drug only for 12days, but there has been no recurrence after 6 months under observation.
Adrenal Cortex Hormones ; Adult ; Clofazimine ; Cyclosporine ; Dapsone ; Fever ; Humans ; Leukocytosis ; Male ; Neutrophils ; Panniculitis* ; Potassium Iodide* ; Potassium* ; Recurrence ; Skin ; Sweet Syndrome* ; Vasculitis