D. Chakraborty, J. Sengupta ,T. Chakraborty1* Received 13 April 2016, revised 06 October 2016
ABSTRACT : A borderline lepromatous leprosy patient was treated with anti-leprosy treatment. During the period of treatment Type 1 reaction developed. The patient was treated with multi drug for second time along with steroid. On completion of MDT the patient was released from treatment though the patient was found to suffer from skin lesion and plantar ulcer with osteomyelitis. The patients was treated with Mercurious solubilis, a homoeopathic medicine for a period of four years three months. At the end of the treatment the skin biopsy revealed the picture of indeterminate leprosy.
Key words: Borderline lepromatous leprosy, Plantar ulcer, Osteomyelitis, Mercurious solubilis, Indeterminate leprosy.
Reactional states in leprosy are varied signs and symptoms of inflammation arising from acute or chronic hypersensitivity brought about by the patient’s immunologic response to antigens of Mycobacterium leprae. Type 1 and type 2 immune-mediated reactions occur in about 30% of patients with multibacillary disease during and after multidrug therapy.
(Walker et al. 2011). The type 1 reactions (T1R) are due to increased cell-mediated immunity and result in localized tissue damage. Steroids are the main treatment, but a systematic review found only three trials of adequate quality that supported this strategy (Van Veen 2008). An evidence-based review revealed that the optimum duration of steroid treatment is
unknown, although some data suggest that longer courses are better, as 20 weeks of treatment yielded better results than 12 weeks of treatment in one study (Rao 2006). No studies have used a dose-per-weight regimen. In this communication a case of borderline lepromatous leprosy with Type 1 reaction with a history of anti leprosy treatment with steroid was treated with Mercurious solubilis and the detailed follow up observations recorded has been presented.