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Multibacillary leprosy — DTM&H MCQ

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HardDermatological Tropical ConditionsMultibacillary leprosyDTM&H

A patient has diffuse symmetric nodules, madarosis and nasal infiltration. Slit-skin smears are strongly positive for acid-fast bacilli. There is no rifampicin resistance and no contraindication to standard therapy. Which WHO operational classification and regimen are correct?

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Correct answer: B — Multibacillary leprosy; rifampicin, dapsone and clofazimine for 12 months

The best answer is “Multibacillary leprosy; rifampicin, dapsone and clofazimine for 12 months”. A positive slit-skin smear classifies leprosy as multibacillary regardless of lesion count. WHO uses the same three drugs—rifampicin, dapsone and clofazimine—for both operational groups, but for 12 months in multibacillary disease and 6 months in paucibacillary disease. A paucibacillary label contradicts the positive smear; omitting clofazimine leaves an incomplete regimen, shortening multibacillary treatment to 6 months undertreats, and dapsone monotherapy invites resistance.

Reference: WHO: Leprosy (Hansen disease): https://www.who.int/health-topics/leprosy