Leprosy type 1 reaction — DTM&H MCQ

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HardTropical bacterial infectionsLeprosy type 1 reactionDTM&H

A 37-year-old woman already on multidrug therapy for leprosy develops acute swelling of existing plaques and new ulnar nerve tenderness with worsening hand weakness. What is the most appropriate treatment?

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Correct answer: B — Prednisolone for reversal reaction

Prednisolone for reversal reaction is the single best answer because type 1 leprosy reaction threatens nerve function and is treated with corticosteroids while continuing antimycobacterial therapy. Stop multidrug therapy is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that stopping multidrug therapy risks relapse and does not treat immune-mediated neuritis.

Reference: Manson's Tropical Diseases; WHO/UKHSA infectious diseases guidance; BNF