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Indian Journal of Dermatology, Venereology, Leprology, Vol. 70, No. 4, July-August, 2004, pp. 250 Letter To Editor Rheumatological manifestations of leprosy Sudhir Kumar Department of Neurological Sciences, Christian Medical College, Vellore, Tamilnadu Code Number: dv04087 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
Copyright 2004 - Indian Journal of Dermatology, Venereology, Leprology |
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