MDT as recommended by the World Health Organization is a safe, effective, and easily administered therapy for leprosy (Table 3). After the first dose, patients are no longer infectious to others, and transmission of leprosy is interrupted. Patients who have completed the prescribed medication regimen are considered cured, and there are virtually no relapses. Treatment can lead to development of acute inflammatory reactions for which additional medications are often required. Type I or reversal reactions, which can occur in patients with any type of leprosy upon commencement of therapy, can be treated with prednisone (Fig. 8B). Type II reactions, which occur in patients with the lepromatous form of leprosy who are undergoing treatment and are caused by formation of immune complexes in association with an excessive humoral immunity reaction, can be treated with thalidomide.
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