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LETTER TO EDITOR
Year : 2004  |  Volume : 70  |  Issue : 4  |  Page : 250

Rheumatological manifestations of leprosy


Department of Neurological Sciences, Christian Medical College, Vellore, Tamilnadu, India

Correspondence Address:
Department of Neurological Sciences, Christian Medical College, Vellore, Tamilnadu, India
drsudhirkumar@yahoo.com



How to cite this article:
Sudhir K. Rheumatological manifestations of leprosy. Indian J Dermatol Venereol Leprol 2004;70:250


How to cite this URL:
Sudhir K. Rheumatological manifestations of leprosy. Indian J Dermatol Venereol Leprol [serial online] 2004 [cited 2019 Oct 22];70:250. Available from: http://www.ijdvl.com/text.asp?2004/70/4/250/12372


Sir,
I read with interest the recent article by Vengadakrishnan et al.[1] They have reported a high occurrence of arthritis in patients with leprosy. However, I would like to make certain observations.
Leprous neuritis leads to a damage of the sensory nerves supplying joints. Therefore, neuropathic (Charcot's) arthropathy involving the weight-bearing joints, such as those of the feet, occurs in more than 10% of patients with leprosy.[2] Involvement of non-weight bearing joints, such as the wrist, has also been reported.[3] Patients may fail to note the development of neuropathic arthropathy due to the absence of pain. This fact was highlighted by a study which found that MRI studies detected significant changes in the feet in all asymptomatic patients with leprosy.[4] Vengadakrishnan et al have not presented data on this aspect in their study.
Another point worth noting while studying the association of leprosy and rheumatoid arthritis (RA) is the efficacy of dapsone in ameliorating the symptoms of RA as effectively as chloroquine and hydroxychloroquine. The mode of its anti-inflammatory action in RA is not clearly understood, but modulation of neutrophil activity or inhibition of neutrophil inflammatory product formation or release appear to play a role.[5]  

   References Top

1.Vengadakrishnan, Saraswat PK, Mathur PC. A study of rheumatological manifestations of leprosy. Indian J Dermatol Venereol Leprol 2004;70:76-8.  Back to cited text no. 1    
2.Horibe S, Tada K, Nagano J. Neuroarthropathy of the foot in leprosy. J Bone Joint Surg Br 1988;70:481-5.  Back to cited text no. 2  [PUBMED]  
3.Carpintero P, Garcia-Frasquet A, Pradilla P, Garcia J, Mesa M. Wrist involvement in Hansen's disease. J Bone Joint Surg Br 1997;79:753-7.  Back to cited text no. 3  [PUBMED]  
4.Maas M, Slim EJ, Akkerman EM, Faber WR. MRI in clinically asymptomatic neuropathic leprosy feet: a baseline study. Int J Lepr Other Mycobact Dis 2001;69:219-24.  Back to cited text no. 4  [PUBMED]  
5.Chang DJ, Lamothe M, Stevens RM, Sigal LH. Dapsone in rheumatoid arthritis. Semin Arthritis Rheum 1996;25:390-403.  Back to cited text no. 5  [PUBMED]  

 

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