Type 2 Lepra Reaction Hypersensitivity
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Leprosy also known as hansens disease hd is a long term infection by the bacteria mycobacterium leprae or mycobacterium lepromatosis.
Type 2 lepra reaction hypersensitivity. 1department of dermatology command hospital pune india. Type 2 lepra reaction is a th2 mediated type iii hypersensitivity reaction in leprosy with a characteristic cutaneous manifestation in the form of erythema nodosum leprosum enl. This nerve damage may result in a lack of ability to feel pain which can lead to the loss of parts of a persons extremities from repeated injuries or infection due to unnoticed.
Type 2 reaction or erythema nodosum leprosum enl occurs in patients with high bacilli load as in patients with multibacillar type leprosy bl and ll. Mechanisms of damage. It generally occurs in patients on treatment but may be encountered in untreated cases.
Infection can lead to damage of the nerves respiratory tract skin and eyes. Dome shaped lesions with ill defined margins. These complexes are responsible for the reaction.
Lupus serum sickness and. Erythema nodosum leprosum enl occurs exclusively in patients near the lepromatous end of the leprosy spectrum bl ll and is more severe. Type iv allergic reactions are also called the delayed type of hypersensitivity or allergic reactions as they occur after at least 24 hours of exposure to the allergen.
Erythema nodosum leprosum type 2 reaction episodic. Type ii hypersensitivity mediated by abs directed towards antigens present on cell surfaces or the extracellular matrix type iia or abs with agonisticantagonistic properties type iib. Type 2 reaction is considered to be more complicated than type 1 reaction due to systemic nature and recurrent episodes.
Type iii allergic reactions can be seen in. Type 2 lepra reaction or erythema nodosum leprosum enl is an immune complex syndrome that occurs mostly in lepromatous leprosy and sometimes in borderline lepromatous leprosy patients. Type 2 lepra reactions.
90 of cases follow the institution of chemotherapy generally within 2 years. Type iv or cell mediated reactions. May precede diagnosis and initiation of therapy.
46 2 are caused by chemical modification of cell surface or matrix associated antigens that generates foreign epitopes to which the immune system is not tolerant. Increased bacterial load later during treatment eruption of evanescent tender red papules nodules most frequently occur on extremities and face blanch on pressure lymph nodes liver and spleen may be painful and enlarged nerves and joints may become swollen and tender. Type ii hypersensitivity reactions fig.
30 of all lepromatous cases have at least one attack of enl. We describe unusual presentations of type 2 lepra reaction in five patients. Lasting for 48 72 hours or a few days poor gc mb leprosy.
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