Morbus Hansen (MH) Reinfection and Inappropriate Methylprednisolone Use
DOI:
https://doi.org/10.55175/cdk.v51i8.938Keywords:
Leprosy, methylprednisolone, Morbus Hansen, Mycobacterium leprae, steroidAbstract
Background: Morbus Hansen (MH), or leprosy, is a chronic granulomatous infection caused by Mycobacterium leprae. This disease still has a negative stigma, leading to ostracism. Methylprednisolone use can affect the risk of leprosy re-infection. Case: A 55-year-old female with complaints of abdominal pain, nausea, vomiting, and weakness accompanied by an active leprosy reaction. The patient had a history of leprosy treatment at the Sumenep Health Center in 2000 and at Sumberglagah Leprosy Hospital in 2004, but did not return for an acid-fast bacilli (BTA) check after therapy. She takes methylprednisolone 4 mg once or twice daily to manage an itch or rash. Her dermatological status was a symmetrical leprosy reaction throughout the body, accompanied by erythematous nodules and ulcerated nodules. Smear MH examination results +3 in indirect bacteriology and 25 bacteria in indirect microbiology. Treatment for multibacillary leprosy for 12–18 months and education were planned to increase patient awareness and compliance and appropriate steroid drug use.
Downloads
References
Kundakci N, Erdem C. Leprosy: A great imitator. Clinics in Dermatology. 2019;37(3):200–12. [cited 2023 May 18]. DOI: 10.1016/j.clindermatol.2019.01.002.
Griffiths C, Barker J, Bleiker T, et al. Rook’s textbook of dermatology. New York: Wiley; 2016. DOI:10.1111/bjd.15625.
Pieter Y , Grijsen M. The burden of leprosy in eastern Indonesia. Lancet 2022 Apr 23;399(10335):1588-99. DOI: 10.1016/S0140-6736(22)00699-7.
Lee DJ, Rea TH, Modlin RL. Leprosy. In: Goldsmith LA, Katz SI, Gilchrest BA, et al, editors. Fitzpatrick’s dermatology in general medicine. 9th Ed. New York: McGraw Hill Medical; 2019.
Chen KH, Lin CY, Su SB, Chencorresponding KT. Leprosy: A review of epidemiology, clinical diagnosis, and management. J Trop Med. 2022;2022:8652062. DOI: 10.1155/2022/8652062.
Azevedo MDCS, Ramuno NM, Fachin LRV, Tassa M, Rosa PS, Belone AFF, et al. qPCR detection of Mycobacterium leprae in biopsies and slit skin smear of different leprosy clinical forms. Brazilian J Infect Dis. 2017;21(1):71–7. [cited 2023 May 18]. DOI: 10.1016/j.bjid.2016.09.017.
Ekayanthi IAD, Darmada IGK, Rusyanti LMM. Morbus Hansen. Fakultas Kedokteran Universitas Udayana .Rumah Sakit Umum Pusat Sanglah, Denpasar [Internet]. 2014. [cited 2023 May 18]. Available from: https://adoc.pub/download/laporan-kasus-morbus-hansen.html.
World Health Organization. Guidelines for the diagnosis, treatment and prevention of leprosy [Internet]. 2022. Available from: https://apps.who.int/iris/bitstream/handle/10665/274127/9789290226383-eng.pdf?us=1.
Maymone MBC, Laughter M, Venkatesh S, Dacso MM, Rao PN, Stryjewska BM, et al. Leprosy: Clinical aspects and diagnostic techniques. J Am Acad Dermatol. 2020;83(1):1–14. DOI: 10.1016/j.jaad.2019.12.080.
Alemu Belachew W, Naafs B, Position statement: Leprosy: Diagnosis, treatment and follow-up. J Eur Acad Dermatol Venereol. 2019;33(7):1205–13. DOI: 10.1111/jdv.15569.
Noviastuti AU, Soleha TU. Morbus Hansen tipe multibasiler (mid borderline) dengan reaksi kusta reversal dan kecacatan tingkat I. Universitas Kedokteran Lampung [Internet]. 2017 [cited 2023 May 18]. Available from: https://juke.kedokteran.unila.ac.id/index.php/medula/article/view/717.
Gunawan HC. Mengenal Morbus Hansen. Bul Alumni FK UNTAR [Internet]. 2020; 3. [cited 2023 May 18]. Available from: https://www.researchgate.net/publication/339617430_Buletin_Alumni_FK_UNTAR_Edisi_3.
Ramos-e-Silva M, Castro MCRd. Mycobacterial infections. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th Ed. Philadelphia: Elsevier; 2018. p.1296-318.
Mohanty P, Naaz F, Bansal AK, Kumar D, Gupta UD. Challenges beyond elimination in leprosy. Internat J Mycobacteriol. 2017;6(3):222. DOI: 10.4103/ijmy.ijmy_70_17.
Kementerian Kesehatan. 2022. Laporan kinerja. Direktorat Pencegahan Dan Pengendalian Penyakit Menular. Jakarta [Internet]. 2022 [cited 2023 May 18]. Available from: http://p2p.kemkes.go.id/wp-content/uploads/2023/03/LAKIP-Setditjen-P2P-Tahun-2022.pdf.
Widaty S, Soebono H, Nilasari H. Panduan layanan klinis diagnosis klinis Morbus Hansen. Perhimpunan Dokter Spesialis Dermatologi dan Venereologi. Jakarta: PERDOSKI; 2017 .p. 80-7.
Walker S, Lebas E, Doni S, Lockwood DNJ, Lambert SM. The mortality associated with erythema nodosum leprosum in Ethiopia: A retrospective hospital-based study. PLoS Negl Trop Dis. 2014;8(3):e2690. DOI: 10.1371/journal.pntd.0002690.
Citrashanty I, Suyoso S, Rahmadewi R. Insufisiensi adrenal sekunder pada eritema nodosum leprosum: Studi profil TNF-α dan kortisol serum. Berkala Ilmu Kesehatan Kulit Dan Kelamin [Internet]. 2016;26(2):1–6. Available from: https://doi.org/10.20473/bikk.V26.2.2014.1-6.
Tanwar S, Singh S. Impact of steroids on long term use: A review. Research Scholar, Department of Pharmacology, Jaipur National University, Jaipur-302017, India [Internet]. 2022 [cited 2023 May 18]. Available from: https://www.researchgate.net/publication/358957478_Impact_of_ steroids_on_long_termuse.
Wardhani IAP, Febriani D, Wijayanti W, Mulianto N. Morbus Hansen multibacillary type mid borderline: A case report. Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta, Indonesia [Internet]. 2022. [cited 2023 May 18]. Available from: https://doi.org/10.37275/bsm.v6i13.638.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 wenly susanto
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
