This survey was to elucidate the bacterial clearance time (BCT) among the patient of L-type and B-group leprosy who had been und.er chernotherapy and foll- ow up with bacterial examination 4 times every year more than 3 years at the Chronic Disease Laboratory of Catholic Medical College. The 99 patients, 53 L-type and 46 B-group, were slected for this study. These patients were classified again into 2 groups: 80 patients with negative bacterial index and 19 patient of posit.ive bacterial index. The patient with negative bacterial index was subdivided into 3 groups by BCT. 1. Rapid decrease group (RA group) BCT<(4years) 2. Standard decrease group (ST group) 4BCT<7 R. Slow decrease group (SL group) 7.
Chronic Disease ; Drug Therapy* ; Humans ; Leprosy* ; Leprosy, Borderline* ; Leprosy, Lepromatous* ; Prognosis*

Global Health ; Humans ; Leprosy ; drug therapy ; Mycobacterium leprae ; drug effects

It is generally believed that the defense against mycobacterium leprae is largely mediated through cell-mediated immunity(CMI) and several investigators have reported a defective CMI in patients with leprosy. especially the lepromatous from. This study was undertaken to ennumerate the peripheral T-cell population in leprosy patients for evaluation of one aspect of its immune status. Fiftu-two patients with leprosy(26 tuberculoid, 17 active lepromatous, 9 inactive lepromatous) entered in this study. All the patients are under regular antileprosy chemotherapy for varing periods(10 months to 14 years). Peripheral blood T0lymphocytes were enumerated by the E-rosette technique and compared with normal healthy control. The results were as follows: The mean T-cell percentage in peripheral blood was 50.6% in 17 active lepromatous leprosy patients, 62.2% in 9 inactive lepromatous leprosy patients, 67.7% in 26 tuberculoid patients and 69.5% in 17 normal healthy controls, There was marked decrease in the peripheral T-cell ratio in active lepromatous group (p<0,005) and less marked decrease in inactive lepromatous group (0.01.
Drug Therapy ; Humans ; Leprosy* ; Leprosy, Lepromatous ; Mycobacterium leprae ; Research Personnel ; T-Lymphocytes

BACKGROUND: Several trials on relapse rates on duration of multibacillary regimens have varying results. OBJECTIVE: To compare the relapse rate among smear-positive Leprosy patients receiving 12 blister packs of multibacillary drug therapy and 24 blister packs of multibacillary drug therapy. METHOD: A review of records of smear positive Leprosy patients seen from 2002 to 2006 was done. Demographic, clinical and therapeutic data were collected. Bacteriologic index was determined from Leprosy Laboratory records. RESULT: A total of 391 patients were found to have complete records for review and analysis. Relapse rate was 11.9%(28) for patients who received 12 blister packs and 1.91%(3) for patients who received 24 blister packs and the difference was found to be statistically significant (p<0.01). Distribution of relapse was statistically significant according to age (p<0.01), bacteriologic index (p<0.01) and clinical spectrum (p<0.01). CONCLUSION: Relapse rates shown among smear positive leprosy patients receiving 12 blister packs vs. those receiving 24 blister packs was statistically higher which differs from previously published studies. Significant predictors were clinical spectrum, bacteriologic index of >3.5, and >4 and number of blister packs.
Leprostatic Agents ; Drug Therapy, Combination ; Leprosy ; Recurrence ; Chronic Disease

BACKGROUND: The novel COVID-19 (Coronavirus Disease 19) predisposes the general population to a high risk of infection. The 106 million population of the Philippines would be considered an at-risk group due to the high density of the populace in cities. As the situation in each country differs during this era of the COVID-19 pandemic, this paper aims to give practical recommendations for safe procedural dermatology practice in the Philippine setting after the lifting of the government-mandated quarantine. METHODS: An online survey was conducted among Philippine Dermatological Society members. The survey was sent electronically on March 22, 2020. RESULTS: A total of 466 or 42% of the PDS’s 1100 current members replied to the survey. The top 10 procedures performed among the respondents are: 1. Electrocautery (N=437, 94.38%), 2. Chemical peeling (N=422, 91.13%), 3. Laser & energy based device treatment (N= 341, 73.65%), 4. Botulinum toxin injection (N=323, 69.76%), 5. Excision (N=263, 56.80%), 6. Acne surgery (N=176, 38.01%), 7. Injectable Filler (N=171, 36.93%), 8. Cryotherapy (N=145, 31.32%), 9. Platelet rich plasma injection (N=111, 23.97%) and 10. Scar revision (N=85, 18.36%). The majority of the respondents have access to personal protective equipment (PPE) such as surgical masks (N=457, 98.7%), face shields (57.67%), goggles (46.00%), protective gown (42.76%) and bonnets (32.83%). Before the government quarantine, the majority (N=375, 81.17%) of respondents see patients on a firstcome, first-serve system. Only 18.83% (N=87) see patients only by appointment. Regarding teledermatology, most respondents answered that they would advise patients to do digital consultation with only a minority responding they would not consider doing teledermatology. CONCLUSIONS: In the Philippine setting, the best ways to prevent COVID infection inthe procedural dermatology setting include: 1. Education of staff and patients on proper exposure prevention and sanitation measures. 2. Ensuring the correct usage of PPE. 3. Ensuring physical distancing and reducing patient wait times by scheduling visits on an appointment basis. 4. Sufficient protocols must be made for sanitation before and after each patient visit. 5. Teledermatology in pre-procedure consults and post-procedure follow-ups would reduce the risk of COVID-19 transmission for both patient and physician.
Leprostatic Agents ; Drug Therapy, Combination ; Leprosy ; Recurrence ; Chronic Disease

Bacteriological index(BI) was calculated by slit-skin smears taken from the earlobe and the dorsal surfaces of the proximal phalanges of the index finger and of the great toe in 110 lepromatous leprosy patients who have been treated regularly by antileprosy chemotherapy. The bacteriaI indices from the three sites were compared, and the results were as follows. 1) Sixteen patients whose BI of the earlobe smear was 4. 0 in average shawed the highest degree of positivity of M. leprae in the smears taken from the finger and the great toe. 2) ln seventy-four patients whose BI of the earlobe smear was l. 0 or higher, eight (10.8%) showed higher BI in smears taken from both the finger and the great toe, fifteen (20. 3%) and twenty-seven(36. 5%) showed approximately the same BI in smears taken from the finger and the great toe, respectively, 3) In thirty-six patients whose BI of the earlobe smear was negative, twelve (33. 3%) showed higher BI in smears taken from both the finger and the great toe. 4) The mean value of BI of the three sites was 3.7 in the earlobe, 3. 2 in the finger and 3. 0 in the great toe. Comparing the BI of the three sites, the finger and the great toe were found to have comparable BI with the earlobe, although the BI of the earlobe was highest. The authors concluded that it was quite reasonable to include the finger and the great toe in slit-skin smears for M. leprae identification, particularly when the BI of the earlobe was negative. A follow-up investigation seems mandatory.
Drug Therapy ; Fingers* ; Follow-Up Studies ; Humans ; Leprosy, Lepromatous ; Mycobacterium leprae* ; Mycobacterium* ; Skin* ; Toes*

The authors investigated serial changes of bacillary and granularity indices from 49 previously non-treated lepromatous leprosy patients under DDS therapy during 24 month period, and the following results were obtained. 1) Pretreatment bacillary index was highest on eye brows, and chins, ear lobes, arms, legs, backs in decreasing order. The proportion of fall of B.I. during therapy showed similar tendencies in each site of smears, the average decrease being 1. 2 in the first year and 0. 8 in the second year. 2) The average granularity index before therapy was 2. 5, the rise of G.I. was rapid during first 12 months, slower during next 6 months, and no significant changes were seen during last 6 months. 3) The changes of G.I. were faster and more sensitive to therapy than that of B.I. Therefore, it. seems more valuable assesing the response of therapy, drug resistance, prognosis, etc 4) 300 mg of DDS per week appears to be sufficient for maintaining the therapeutic dosage.
Arm ; Chin ; Drug Therapy ; Ear ; Equidae ; Humans ; Leg ; Leprosy, Lepromatous ; Mycobacterium* ; Prognosis

Three cases of leprosy were successfully treated with a tuberculo-protein complex, Tubercin-3, which was prepared from Mycobacterium tuberculosis by Chung( J. Korean Med. Ass. 17:427-431, 1974) and no noticeable side effects were observed. The three cases were brought to us without leprosy medication since their disease was recently diagnosed. Daily inoculations of Tubercin-3, 1.0 microgram on the forearm, subcutaneously for 8 months in Case 1, 7 months in Case 2, and 6 months in Case 3, cleared them of their lepromatous lesions.
Adult ; Bacterial Proteins/therapeutic use* ; Case Report ; Child ; Female ; Human ; Leprosy/drug therapy* ; Mycobacterium tuberculosis*

Attention has been paid to the thiocarbanilide derivative and the authors synthesized some new compounds of thiocarbanilides for experimental studies on tuberculosis and leprosy. The series of newly synthesized chemical compounds of thiocarbanilides were studied for comparision with the already known antimycobacterial agents; INH, PAS, Streptomycin and D. D. S. The strains of Mycobacterium tubercubsis (H37 Rv, Ravenel, and B. C. G.) and Mycobacterium phlei were used for the in vitro experiments. In the in vivo experiments, the strain of Mycobacterium tuberculosis var. bovis (Ravenel) was employed. The strain of Mycobacterium leprae murium (Hawaiian strain) was used for the murine leprosy experiments. The experimental animals for the in vivo tests were white mice (CFW strain) and these were extensively employed in tuberculosis and leprosy as well. Sixteen cases of Various types of human leprosy, were treated with one of the newly synthesized thiocarbanilides (L-4). Among the newly synthesized chemical compounds of thiocarbanilides studied for their antituberculous and antimurine leprosy activity in vitro and in vivo experiments, two compounds were shown to be suppressive agents for those infections without significant toxicity. These two compounds were named tentatively as L-1 and L-4. 1) LD50 of L-1 was 1,054 mg/kg and that of L-4 was 1,028 mg/kg, while the LD50 of INH was 650 mg/kg and PAS was 4,000mg/kg orally in the experimental animals. 2) L-1 and L-4 showed remarkable suppressive activity in vitro using solid media with 100r/ml. concentration. These data were parallel to 1r/ml. of INH and 50r/ml. of PAS. The inferiority of L-1 and L-4 to INH and PAS in vitro studies might have been due to the water insolubility of these compounds while INH and PAS were readily soluble in water. 3) In vivo experiments with L-1 showed a much-more superior antituberculous effect than was found with INH and PAS. 4) A method of grading the bacterial count in a homogenized tissue suspension of visceral organs (lungs, liver, spleen and kidneys) using the simple technique of the Gaffky scale was accurate and time saving technique in screening the results of the chemotherapeutic agents in tuberculosis. 5) Among the newly synthesized compounds L-4 showed the most remarkable suppressive effect on murine leprosy. The suppressive results were similar to those of INH. 6) The method of measuring the size and the weight of leproma at the inoculated site was simple and is an adequate screening test for chemotherapeutic effect in murine leprosy. 7) In the trials with human leprosy 16 cases of various types, using L-4, the effectiveness in clinical as well as in bacteriological improvement was remarkable. a) After L-4 treatment decrease in bactriologica1 indices and remarkable clinical improvement after a relative1y short period of treatment were observed. b) L-4, up to the maximum daily dose of 500 mg, can be safely administered orally to the patients without any significant side reactions. c) L-4 could be used with remarkable clinical improvement for the patients in lepra reactions.
Adult ; Animals ; Comparative Study ; Erythema Nodosum/drug therapy ; Female ; Human ; Leprosy/*drug therapy ; Male ; Mice ; Thiourea/*therapeutic use

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