A patient taking multi-drug therapy (MDT) presents with worsening of existing lesions and nerve involvement. What will be your next best step of action?

Options

1. Stop MDT, start systemic corticosteroids
2. Continue MDT, start systemic steroids
3. Stop MDT thalidomide
4. Continue MDT, start thalidomide

Correct Answer

Continue MDT, start systemic steroids

Explanation

The patient is experiencing a Type 1 lepra reaction (reversal reaction), which occurs during leprosy treatment. Management involves continuing MDT (do not stop anti-leprosy treatment) and adding systemic corticosteroids to reduce inflammation and prevent nerve damage. Stopping MDT would lead to disease progression.

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