少菌型麻风固定疗期的联合化疗

对WHO推荐的少菌型麻风联合化疗(MDT)方案的疗效进行了研究,并与常规DDS单疗的疗效进行了比较。研究对象为54例具单个皮损的新发少菌型病人。初诊时进行临床分类、皮肤涂片查菌、病理检查和麻风菌素试验,然后随机分为两组。MDT组为28例患者(TT21例,BT 7例),给予WHO推荐的少菌型MDT方案,疗期6个月。在治疗期间每月随访一次,治疗结束后每隔半     

少菌型麻风的联合化疗——7.5年经验

作者用 WHO 推荐的少菌型麻风联合化疗方案(PBR)治疗了323例少菌型麻风病人并且随访了7.5年。PBR 的疗期为6个月,如果在6个月后红斑和浸润持续存在,临床疗效不明显,则治疗延长6个月。结果:完成6个月治疗的214例病人中,有131(61.2%)例在治疗6个月后皮损完全消退,71例(33.2%)皮损部分消退,9例(4.2%)未见皮损变化.3例(1.4%)麻风菌素试验阴性的病人经     

少菌型病人MDT后的复发情况——一项临床研究

作者对印度孟买1509例完成了少菌型方案治疗病人的复发情况做了研究。分类按印度麻风专家协会标准。MDT以WHO的方案为基础修改:(1)MDT一直持续到临床阴转。完成6个月治疗后仍无法确定阴转者,继续用氨苯砜(DDS)治疗至少6个月或至临床阴转。如治疗12个月或18个月后病人仍活动则加用氯苯吩嗪,按WHO的多菌型方案治疗,持续至临床阴转。(2)有5块以上皮损的病人开始就加用氯苯吩嗪。随访期为6个月到5年,随访     

麻风病

20131698多菌型麻风患者实施6个月联合化疗后4年疗效观察/沈建平(中国医科院、北京协和医学院皮研所),李进岚,余美文…//临床皮肤科杂志.-2013,42(4).-251~253对79例多菌型麻风患者予6个月的多菌型方案治疗,然后每年进行临床和细菌学随访,连续4年,观察麻风反应发生率。结果:79例患者疗前细菌指数平均2.89±1.40,停药满1,2,3,4年时,细菌指数分别为0.97,0.71,0.38和0.21,细菌阴转率分别为36.7%,48.1%,68.4%和84.8%。共有33例次发生麻风反     

3户发现18例麻风

麻风病人的家属发病率较高,我们对麻风病人家属进行调查时发现,有3个家庭先后发现18例麻风病人,现报道如下.临床资料 家庭1,全家6口人均被诊断为麻风.其中例1男,1941年出生,1967年诊断为LL麻风(MB)并足底溃疡,1969年DDS单疗治愈出院.例2女,例1之妻子,1946年出生,1966年确诊为LL麻风(MB),住院治疗3年后与例1于1969年结婚后出院,DDS单疗至1976年判愈,夫妻俩为首发者.例3,二女儿,1976年出生,1992年发病,病期6个月时被检查发现,诊断为TT(PB)麻风,按少菌型联合.化疗方案治疗6个月,于1994年判愈至今未复发.例4,儿子,1971年出生,2005年5月发病,2006年诊断为BT麻风(PB),左侧爪形手,病期14个月,确诊后给予二联联合化疗半年治疗,于2008年12月判愈.     

多菌型麻风患者联合化疗6个月后停药随访7年结果分析

目的:分析多菌型麻风患者经过6个月联合化疗后停药,随访7年的结果。方法:对新发或复发未经治疗的多菌型麻风患者给予WHO联合化疗多菌型方案治疗6个月,停药后观察7年,评价临床和细菌学疗效。结果:共收录多菌型麻风患者114例,中途退出43例,71例纳入分析。疗前患者平均细菌指数为2.93±1.39,停药满7年时所有患者细菌指数阴转,平均年下降0.42。7年中共观察到麻风反应38人次,反应频率为53.5%。有1例在停药13个月时复发,复发率为0.05/100人年。结论:多菌型麻风患者6个月联合化疗有效。联合化疗6个月患者的细菌指数变化和麻风反应与报告的经1年或2年联合化疗的多菌型患者情况相似。     

114例MB麻风6个月联合化疗后随访3年细菌指数变化

目的:评价6个月联合化疗方案治疗MB麻风细菌指数变化.方法:采用世界卫生组织多菌型方案对新发114例查菌阳性麻风患者治疗6个月,并对观察治疗前后及随访3年中每年细菌指数的变化进行了分析.结果:114例麻风疗前平均细菌指数3.01,其中分别有108、97、88、83例完成治疗和1年、2年、3年随访.1例停止治疗后13个月复发.治疗结束、1年、2年和3年随访时平均细菌指数值分别为1.82、1.01、0.63和0.39.3年随访患者完成治疗、1年、2年和3年随访时细菌阴转率分别为19.28%、27.71%、46.99%和69.88%.结论:6个月联合化疗后随访3年,细菌阴转率持续上升.由于随访时间较短,且已有复发病例报告,对6个月联合化疗方案疗效需进一步随访观察.     

用Diucifon治疗麻风

麻风病的治疗是现代医学的迫切问题之一.作者用Diueifon, P.P.-(2,4-二氧-6-甲基嘧啶基-5-砜氨)二苯砜,作治疗研究.作者把121例用Diucifon治疗的病人分成3组(组1,20例为未经治病人;组2,76例为在用Diucifon治疗前用各种抗麻风制剂无效,病情活动者;组3,25例为对抗麻风治疗耐药或病程明显迁延者),同时把接受其它治疗方法的87例病人分成2组(17例为DDS治疗组,70例为DDS、Ciba-1906、吩嗪类药物联合治疗组)做为对照组进行比较研究.作者发现在用0.4～0.6g/昼夜Diueifon的条件下有明显的抗麻风作用.用药1.5～2个月,特异     

多菌型麻风用WHO联合化疗方案治疗和长期随访后的复发

作者报告用WHO联合化疗(MDT)方案治疗多菌型麻风(MB)病人长期随访后的复发。 35例MB病人用WHO/MDT方案治疗2年。疗前,35例病人中14例从未接受过抗麻风治疗,15例曾经不同疗期的氨苯砜(DDS)单疗,5例在DDS单疗后又经不同疗期的利福平(RFP)合并DDS治疗,1例接受过6个月的RFP+DDS+氯苯吩嗪(CLO)治疗。35例病人     

扎伊尔少菌型麻风的原发性氨苯砜耐药

在鼠足垫可分离麻风杆菌及证实DDS耐药时,有文献证明一例BT型麻风原发性DDS耐药演变为BL型。基于继发性DDS药流行率增加,推测会有较多的原发性DDS耐药患者。继发性DDS耐药仅在多菌型麻风中发生,而原发性DDS耐药可发生于临床光谱各类型麻风中。作者在扎伊尔见到2例少型菌原发性DDS耐药患者。例1,男,8岁,5岁时患BT型麻风,给以DDs每周100mg治疗,在治疗中新皮损继续出现。1980年,1月起使用RFP一次量为30mg/kg及B663每周200mg,监服治疗5个月,     

Treatment of paucibacillary leprosy with a regimen containing rifampicin, dapsone and prothionamide.

Ninety paucibacillary leprosy patients having indeterminate (I), tuberculoid (TT) and borderline tuberculoid (BT) type of leprosy with bacterial index (BI) of less than two on the Ridley scale were treated with rifampicin (RFM) 600 mg once a month, dapsone (DDS) 100 mg daily and prothionamide (PTH) 250 mg daily. Treatment was stopped at the end of six months. The patients tolerated the drugs fairly well and in only two patients the drugs had to be stopped (in one due to jaundice and in the other due to gastric intolerance). About 6% of patients had early reactions which subsided with additional steroid therapy. The inactivity rate was 60% at six months and this improved to 96% at 12 months. No cases of late reactions and relapses were encountered in the limited follow-up period of six months; and a longer follow-up is necessary for ascertaining the relapse rates. The preliminary results however suggest that the addition of prothionamide to the standard WHO paucibacillary regimen is well-tolerated with increased inactivity rate and fewer instances of late reactions.     

Clinical assessment of paucibacillary leprosy under multidrug therapy-three years followup study

408 skin smear negative paucibacillary leprosy cases who had completed six months MDT were kept under surveillance for three years. The clinical assessment at the end of surveillance showed that 276 (82%) of all the cases attained inactivity. Two patients who were inactive showed signs of relapse. Five patients showed more activity though they were regressing under treatment. The inactivity rate was much higher amongst the patients with 1 to 3 skin lesions (88%) as compared to the patients with greater than or equal to 4 lesions (60%). The difference was statistically significant (P less than 0.001). The past treatment before MDT did not appear to influence the clinical course of the disease. 17% of the patients essentially border-line type continued to show signs of activity even after 3 years surveillance indicating the need for triple drug therapy (to be treated as multibacillary). However large scale data on relapse rate would be essential before the efficacy of WHO short-term therapy for paucibacillary leprosy is evaluated.     

Respuesta al tratamiento con lámina artificial en pacientes con uña en pinza

ObjectiveTo evaluate the effects of treatment with artificial nail plate and the level of satisfaction in patients with a diagnosis of claw nail treated in two dermatological reference centers between 2016 and 2020.MethodsObservational cohort study. Patients with a diagnosis of pincer nail who received conservative management through the application of an artificial nail plate and had six-month follow-up were included. The curvature index of the nail plate was compared before and after six months of use of the artificial nail plate and satisfaction with the treatment was evaluated.ResultsA total of 17 nail plates from nine women were included. Hallux was the predominantly affected finger, 44.4% of patients reported being satisfied with the conservative management after six months of use and 33.3% reported being very satisfied. No patient presented adverse events. The median initial curvature index was 1.25 (IQR 1.17-1.44) with minimal changes at follow-up. After 6 months of use of the artificial sheet, the curvature index decreased by -0.08 (95% CI -0.47 to 0.02), p-value 0.166 evaluated in the final follow-up.ConclusionsThe use of artificial foil for the correction of a clamping nail is considered a comfortable, conservative and safe tool for patients. Longer follow-up times are required to determine the risk of recurrence.     

Clinico-histopathological study of multidrug therapy in indeterminate leprosy

A study was undertaken in 42 patients with indeterminate leprosy to evaluate the efficacy of multidrug therapy (MDT) in Indeterminate leprosy for 12 months. The main clinical finding was a single hypopigmented macule in 31 (73.8%) of the 42 cases. Histopathologically all cases showed lymphohistiocytic infiltration around skin appendages and dermal nerves. At the end of six months of MDT all the cases were evaluated clinically and 33 (85.5%) showed marked improvement or total inactivation while the lesions were still active clinically in 21.4% cases. Histopathological examination of lesions in 30 patients showed complete histological resolution in 9 cases only. At the end of one year of treatment it was found that 28 cases (66.3%) had become inactive and only 2 (4.7%) were found to be still active.     

A study on the impact of FD-MDT on 200 leprosy patients

A study was carried out from June 1999 to June 2001 to assess the impact of fixed duration multidrug therapy (FD-MDT) in newly detected cases of leprosy in terms of clinical and neurological improvement and changes in the bacillary index of skin smear for AFB. 200 new leprosy cases (both PB & MB) were started on FD-MDT. Of these 200 cases, 16 were of pure neuritic leprosy. After treatment, out of 184 cases with typical skin lesions of leprosy, all 26 PB cases showed inactivity of skin lesions, and, of the remaining 158 MB cases, 40.5% showed inactivity and 59.5% showed complete resolution of skin lesions. Out of 68 skin smear-positive cases, 42 cases with a BI of < or = 3 became smear-negative, while others showed gradual fall in the BI. Such heavily bacilliferous cases were continued with treatment for 1 more year to prevent relapse. As FD-MDT alone does not cure established sensory and motor impairment, it did not show any change in 19% of the patients presented with permanent sensory motor disturbance. FD-MDT prevents progression of sensory/motor disturbance.     

RFP, 8663和DDS联合治疗多菌型麻风的现场研究—三年结果

本文报告198 3-1986年间扬州市及东台县活动性多菌型麻风用RFP,B663和DDS联合治疗3年的可行性及疗效.3年来该地皮肤涂片阳性的多菌型麻风共591例,接受联合治疗者569例(96.3%),每年RFP和B663的监服率分别为96.7%,94.04%和93%.在可供3年结果分析的303例中,196例(64.7%)显示皮肤涂片阴转或临床不活动,其余均有不同程度的进步.皮肤查菌BI每年平均下降0.78,ENL和神经炎的发生频率随着疗程的增加而明显减少,未见其它严重毒副作用.初步结果提示本研究方案的可行性及疗效是满意的.3年治疗期间皮肤涂片阴转的196例中已有139例停药观察一年,均未见复发.     

157例妊娠梅毒孕妇规范治疗后新生儿血清学追踪观察

目的:观察妊娠梅毒孕妇经过规范治疗后新生儿血清学情况。方法:分析2012年1月至2016年6月我院产前门诊及各区县保健站妊娠梅毒孕妇及所生新生儿的梅毒感染情况。结果:157例新生儿中,TRUST和TPPA同时阳性40例(25.5%), TPPA单阳性者106例(67.5%)。母亲TRUST及TPPA双阳性时,新生儿TRUST阳性40例, TPPA阳性为105例,均高于母亲TPPA单阳性时的新生儿比例。40例TRUST及TPPA双阳性的新生儿中,39例(97.5%)于出生后6个月TRUST转阴,转阴高峰在出生后3个月(32例,80.0%);8例(20.0%)于出生后6个月TPPA转阴,25例(62.5%)于出生后9个月转阴,12个月全部转阴。106例TPPA单阳性新生儿中,13例(12.3%)TPPA于出生后6个月转阴,75例(70.7%)于出生后9个月转阴,12个月全部转阴。所有随访的新生儿无一例出现先天梅毒。结论:妊娠梅毒孕妇规范治疗后能够明显降低先天梅毒感染率。     

Indeterminate leprosy: a therapeutic evaluation.

Out of 50 cases of indeterminate leprosy, 46 were male and 4 were female. The only clinical finding was a single hypopigmented macule in 38 (76%) cases. Nine (18%) patients had two and three (6%) cases had three hypopigmented macules. All patients were treated with multidrug therapy for one year. At the end of six months, the lesions were still active in 12 (24%) cases. At the end of one year of treatment it was found that 33 (66%) patients became inactive and 3 (6%) cases were still to be active. The study shows that all indeterminate leprosy cases must be treated with multidrug therapy till all signs of activity are subsided.     

Immunological upgrading with combined immunotherapy and chemotherapy in a lepromatous leprosy patient: a case report.

Immunotherapy with Mycobacterium w was given, in addition to standard multidrug therapy (MDT) to a lepromatous leprosy (LL) patient with a bacteriological index (BI) of 6. After 15 months of treatment this patient attained bacteriological negativity and clinical inactivity. Histopathologically the patient upgraded to borderline-tuberculoid at 12 months, and at 15 months showed features of nonspecific infiltration in the dermis. The rapid immunological upgrading seen in the patient is highlighted in this paper.     

An evaluation of clinical and histopathological status in paucibacillary leprosy patients after completion of fixed duration therapy

The present study was carried out involving 25 patients with paucibacillary leprosy who attended the outpatient department of dermatology of Father Muller's Medical College Hospital during the period January 2001 to March 2002. All the patients were examined clinically and histopathologically at the beginning and at the end of six months of MDT and relevant data recorded. Clinicopathological correlation with histopathological classification before MDT was 72% and 68% at the end of MDT in our study. At the end of treatment 4 (16%) cases were clinically active and 8 (32%) were histopathologlcally active. The study showed that active cases were significantly reduced as a result of MDT, both clinically and histopathologically. The histopathological activity that outlasts MDT may be due to the bacillary fragments that persist; but clinical activity coupled with histopathological activity seen in 2 patients at the end of 6 months of MDT was possibly an indicator of relapse and these patients and similar others need to be followed up for a longer duration. In this study, resolution of granuloma and clinical activity after completion of MDT were assessed.