ABSTRACT
Hansen disease or leprosy is one of the ancient skin diseases that still take a toll on mankind physically, socially, and psychologically. The World Health Organization has recommended the use of multidrug therapy (MDT) constituting dapsone, rifampicin, and clofazimine since 1981. Adverse effects of MDT are not uncommon during routine therapy. Knowledge of life-threatening or serious adverse effects, for example, dapsone hypersensitivity syndrome, methemoglobinemia, hemolytic anemia, agranulocytosis, thrombocytopenia, hepatitis, fatal enteropathy, etc., is essential by the treating physician or dermatologist. There are very limited reports of serious adverse effects of second-line drugs or alternative drugs such as minocycline, ofloxacin, and clarithromycin. Type I and type II lepra reactions are also encountered in the course of disease, but they are not directly related to the therapies of leprosy. Exfoliative dermatitis, morbilliform eruption, erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome–like eruptions, or generalized lymphadenopathy; fever with pallor and pharyngitis; epigastric distress, vomiting unrelated to meals, intermittent abdominal pain, malabsorption; ecchymoses; and bleeding from gums are alarming clinical features that require very close monitoring. Therefore, a high index of suspicion of any underlying serious complications, thorough clinical examination and close laboratory monitoring, and prompt treatment are essential to manage such emergencies.
