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4. Skin diseases
Treatment recommended by the WHO, based on the simplified clinical classification of leprosy
Multibacillary leprosy Paucibacillary leprosy Paucibacillary leprosy
(single skin lesion)
(more than 5 skin lesions) (2 to 5 skin lesions)
C hild ren un d er dapsone P O: 2 5 m g on ce dapsone P O: 2 5 m g on ce
1 0 years d aily, self-ad m in istered d aily, self-ad m in istered
+ rifampicin P O: 3 0 0 m g + rifampicin P O: 3 0 0 m g
on ce m on thly, un d er on ce m on thly, un d er
sup ervision sup ervision
+ clofazimine P O: 1 0 0 m g
on ce m on thly, un d er
sup ervision
an d 5 0 m g 2 tim es w eek ly,
self-ad m in istered 4
C hild ren betw een dapsone P O: 5 0 m g on ce dapsone P O: 5 0 m g on ce
1 0 an d 1 4 years d aily, self-ad m in istered d aily, self-ad m in istered
+ rifampicin P O: 4 5 0 m g + rifampicin P O: 4 5 0 m g
on ce m on thly, un d er on ce m on thly, un d er
sup ervision sup ervision
+ clofazimine P O: 1 5 0 m g
on ce m on thly, un d er
sup ervision
an d 5 0 m g on altern ate
d ays, self-ad m in istered
A d ults dapsone P O: 1 0 0 m g on ce dapsone P O: 1 0 0 m g on ce rifampicin P O: 6 0 0 m g
d aily, self-ad m in istered d aily, self-ad m in istered + ofloxacin P O: 4 0 0 m g
+ rifampicine P O: 6 0 0 m g + rifampicine P O: 6 0 0 m g + minocycline P O: 1 0 0
mg
on ce m on thly, un d er on ce m on thly, un d er
sup ervision sup ervision
+ clofazimine P O: 3 0 0 m g
on ce m on thly, un d er
sup ervision
an d 5 0 m g on ce d aily,
self-ad m in istered
D uration 1 2 m on ths 6 m on ths sin gle d ose
Treatment of leprosy reactions
– R eversal or d ow n grad in g reaction s: prednisolone (or prednisone) P O: 1 m g/ k g/ d ay for
3 to 5 d ays then p rogressively d ecrease the d osage (red uce the d osage by 1 0 % each
w eek ).
– E rythem a n od osum lep rosum : clofazimine P O, 1 0 0 to 3 0 0 m g/ d ay associated w ith
an
N S A I D ( d o n ot ad m in ister d osages eq ual to or greater than 3 0 0 m g/ d ay for m ore
than 3 m on ths).
115
Treatment recommended by the WHO, based on the simplified clinical classification of leprosy
Multibacillary leprosy Paucibacillary leprosy Paucibacillary leprosy
(single skin lesion)
(more than 5 skin lesions) (2 to 5 skin lesions)
C hild ren un d er dapsone P O: 2 5 m g on ce dapsone P O: 2 5 m g on ce
1 0 years d aily, self-ad m in istered d aily, self-ad m in istered
+ rifampicin P O: 3 0 0 m g + rifampicin P O: 3 0 0 m g
on ce m on thly, un d er on ce m on thly, un d er
sup ervision sup ervision
+ clofazimine P O: 1 0 0 m g
on ce m on thly, un d er
sup ervision
an d 5 0 m g 2 tim es w eek ly,
self-ad m in istered 4
C hild ren betw een dapsone P O: 5 0 m g on ce dapsone P O: 5 0 m g on ce
1 0 an d 1 4 years d aily, self-ad m in istered d aily, self-ad m in istered
+ rifampicin P O: 4 5 0 m g + rifampicin P O: 4 5 0 m g
on ce m on thly, un d er on ce m on thly, un d er
sup ervision sup ervision
+ clofazimine P O: 1 5 0 m g
on ce m on thly, un d er
sup ervision
an d 5 0 m g on altern ate
d ays, self-ad m in istered
A d ults dapsone P O: 1 0 0 m g on ce dapsone P O: 1 0 0 m g on ce rifampicin P O: 6 0 0 m g
d aily, self-ad m in istered d aily, self-ad m in istered + ofloxacin P O: 4 0 0 m g
+ rifampicine P O: 6 0 0 m g + rifampicine P O: 6 0 0 m g + minocycline P O: 1 0 0
mg
on ce m on thly, un d er on ce m on thly, un d er
sup ervision sup ervision
+ clofazimine P O: 3 0 0 m g
on ce m on thly, un d er
sup ervision
an d 5 0 m g on ce d aily,
self-ad m in istered
D uration 1 2 m on ths 6 m on ths sin gle d ose
Treatment of leprosy reactions
– R eversal or d ow n grad in g reaction s: prednisolone (or prednisone) P O: 1 m g/ k g/ d ay for
3 to 5 d ays then p rogressively d ecrease the d osage (red uce the d osage by 1 0 % each
w eek ).
– E rythem a n od osum lep rosum : clofazimine P O, 1 0 0 to 3 0 0 m g/ d ay associated w ith
an
N S A I D ( d o n ot ad m in ister d osages eq ual to or greater than 3 0 0 m g/ d ay for m ore
than 3 m on ths).
115
