Reaksi Reversal pada Release From Treatment Morbus Hansen Multibasiler (MB) - Chrysilla Calistania; Hendrik Kunta Adjie (Cermin Dunia Kedokteran, 2017)
Introduksi Terdapat dua jenis reaksi kusta, yaitu reaksi tipe 1(reaksi reversal) dan reaksi tipe 2 (reaksi ENL). Reaksi reversal setelah selesai pengobatan penting dibedakan dari relaps mengingat penatalaksanaannya berbeda. Kasus Pria, 30 tahun asal Sumbawa, dengan keluhan nyeri dan mati rasa pada jari manis dan kelingking tangan kanan mendadak disertai membengkoknya kedua jari tersebut. Pasien sudah didiagnosis kusta sekitar 2 tahun dan telah menyelesaikan pengobatan MDT-MB selama 1 tahun. Didapatkan lesi infiltrat eritematosa, sirkumskrip, ukuran lentikuler pada lengan kanan bawah; clawing dan gangguan fungsi sensorik-motorik pada digiti IV-V manus dekstra; pembesaran nervus auricularis magnus dekstra dan nervus ulnaris dekstra dengan konsistensi keras disertai nyeri. Pasien diterapi prednison selama 12 minggu (tapering off). Didapatkan perbaikan kondisi klinis bermakna. Simpulan Diagnosis dan tatalaksana yang tepat penting untuk mencegah disabilitas permanen akibat reaksi kusta. Reaksi kusta berespon sangat baik terhadap prednison.Introduction There are two types of leprosy reactions, type-1 reaction (reversal reaction) and type-2 reaction (ENL reaction). Reversal reaction after medical treatment completion is crucial to be differentiated from relapse, considering the difference of management. Case Male, 30 years old, Sumbawa origin, with sudden pain and numbness on his right fourth and fifth fingers followed by clawing. The patient was already diagnosed with leprosy since 2 years and has completed MDT-MB. Erythematous, circumscribed, lenticular sized infiltrate lesions was found in the lower arm; clawing as well as sensory and motor deficit in right fourth and fifth fingers; hard enlargement of right great auricular and ulnar nerve with pain. Patient was treated with prednisone for 12 weeks (tapering off). The patient’s clinical conditions was significantly improved. Conclusion Accurate diagnosis and management are indispensable to prevent permanent disability caused by leprosy reaction. Leprosy reaction during release from treatment responds especially well on prednisone administration.