Introduction

Hensen’s disease, or more commonly known as Leprosy, is a bacterial infection that causes damage to your nerves, muscles, skin, eyes, and respiratory tract. It can also cause permanent paralysis, blindness, and damage to your hands, face, and feet. This condition causes you to have patches of pale or discoloured skin.¹

Clinical features

Onset and timing 

Type 1 leprosy reactions typically affect the skin and the nerves, and the patient might not show systemic symptoms, which is why it is classified as mild and severe.^1,2 

Skin manifestations

• Erythema, induration of any existing lesions 
• Ulceration during very intense reactions

Nerve involvement

• Pain and tenderness
• Affects nerves
• Muscle weakness
• Paralysis
• Deformity
• Loss of sensation

Triggers of type 1 reactions

There are many triggers of type 1 leprosy reactions, including:^1,2

• Increased response of bacteria, causing leprosy in the body
• Multidrug therapy
• Stress
• Trauma
• Hormonal changes
• Certain vaccinations

Diagnosis

To diagnose type 1 reaction of leprosy, you will be examined to determine if you have borderline leprosy that develops symptoms within a few months of starting treatments. To diagnose you with type 1 reaction leprosy, the doctor will conduct a number of tests, including:^1,3

• Assessment: asking questions about when and how the symptoms started, the doctor may also look at any lesions in the skin and check for any nerve damage 
• Nerve function test
• Skin biopsy

Management and treatment

For treating a type 1 reaction, it is important to manage it with supportive care, which involves:^1,3,4

• Corticosteroids: it is the first-line of treatment, mainly using prednisone 
• Painkillers: to manage nerve pain 
• Monitoring, in case of any flare-ups
• Antibiotics for certain cases

Prognosis

If you believe you have type 1 reaction leprosy, it is important to seek medical attention soon, because early detection may give you a better outcome with the treatment too. The sooner you begin treatment, the less likely it is that you have more severe or lasting symptoms. Antibiotics could help to cure the infection, but any nerve damage and disabilities caused by leprosy can be permanent.^1,4

Prevention and monitoring

These days, it is not as common to get in contact with leprosy, but if you have contact with someone with leprosy, it is important to get tested even before you start showing symptoms. The earlier it is recognised, the better the treatment outcome will be. If it is left untreated for too long, it could lead to severe complications and in rare cases, death.^1,5

Summary

Type 1 reaction of leprosy is a mild form of the leprosy infection that is caused by bacteria. It causes you to have damage in the skin, muscles, and respiratory tract. Though it is a mild reaction, it is still important to seek medical attention if you feel unwell or have been in contact with someone with leprosy. This is because the earlier the symptoms are recognised, the better the treatment will work and manage the condition. However, if it is left untreated, it could have some long-lasting effects, such as paralysis and permanent nerve damage.