Indian Journal of Dermatology
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Table of Contents 
CORRESPONDENCE
Year : 2018  |  Volume : 63  |  Issue : 4  |  Page : 354-355
Authors' Reply


1 Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
2 Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India

Date of Web Publication9-Jul-2018

Correspondence Address:
Dr. Indrashis Podder
Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijd.IJD_156_18

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How to cite this article:
Podder I, Saha A, Bandyopadhyay D. Authors' Reply. Indian J Dermatol 2018;63:354-5

How to cite this URL:
Podder I, Saha A, Bandyopadhyay D. Authors' Reply. Indian J Dermatol [serial online] 2018 [cited 2020 Jul 10];63:354-5. Available from: http://www.e-ijd.org/text.asp?2018/63/4/354/236218




Sir,

We thank the authors of this letter for their interest in our article and their critical appraisal of our work. We would like to clarify some of the points they have raised in their letter.

As we dealt with only paucibacillary leprosy cases (tuberculoid, borderline tuberculoid, and indeterminate types), Type 2 reaction was not considered, as the latter occurs almost exclusively in lepromatous leprosy (LLp and LLs) and occasionally in borderline lepromatous leprosy.[1]

Although reaction was not considered separately during grading, we considered erythema, infiltration, and appearance of the lesions during their clinical assessment at all visits; erythema and edema (infiltration) being the most common clinical presentations of Type 1 reaction.[1],[2] Another important clinical characteristic was neuritis characterized by nerve thickening and tenderness,[1] which were considered during the evaluation of our patients.

In our study, 14% of patients presented with reaction at baseline, while 2.3% had reaction at the last follow-up. This decline was not statistically significant (P =0.11, Chi-square test).

Histologically, we considered epidermal and dermal status including edema and cellular infiltration, although reaction was not evaluated separately.

At the end, we agree with the authors that clinical scoring as well as the histopathological assessment should preferably include Type 1 reaction along with a larger sample size and prolonged follow-up period in order to correctly assess the efficacy of treatment with multidrug therapy-paucibacillary regimen.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Jopling WH, McDougall AC. Handbook of Leprosy. 5th ed. New Delhi: CBS Publishers and Distributors; 2015. p. 82-91.  Back to cited text no. 1
    
2.
Lockwood DN, Vinayakumar S, Stanley JN, McAdam KP, Colston MJ. Clinical features and outcome of reversal (type 1) reactions in Hyderabad, India. Int J Lepr Other Mycobact Dis 1993;61:8-15.  Back to cited text no. 2
    




 

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