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Leprosy is a long‐term infectious disease. Leprosy bacteria cause damage to the skin and peripheral nerves (nerves outside the brain and spinal cord). This damage can stop nerves from working normally and cause disability. Corticosteroids, especially prednisolone, are often used to treat nerve damage in leprosy, but their long‐term effect is uncertain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Leprosy is a chronic infectious disease. Leprosy bacteria cause damage to skin and peripheral nerves which may result in nerve function impairment and disability. Decompressive surgery is used for treating nerve damage although its effect is uncertain. Two randomised controlled trials (RCTs) were included in the review and examined the added benefit of surgery over prednisolone for treatment of nerve damage of less than six months duration. Both trials were at high risk of bias. Two years from the start there was very low quality evidence of no significant difference in nerve function improvement between people treated with surgery plus prednisolone or with prednisolone alone. Adverse effects of decompressive surgery were not adequately described. No additional trials were identified when searches were updated in 2010 and 2012. Decompressive surgery is used for treating nerve damage in leprosy but the available evidence from RCTs is of very low quality and does not show a significant added benefit of surgery over steroid treatment alone. Well‐designed RCTs are needed to establish the effectiveness of the combination of surgery and medical treatment compared to medical treatment alone.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Three million persons are affected by nerve damage caused by leprosy (Hansen's disease) worldwide. Leprosy is a chronic infectious disease caused by the bacterium Mycobacterium leprae. About 30% of people with leprosy develop nerve damage that can lead to loss of normal sensation and skin damage. The skin can crack and become infected and ulcerated. Impairment of the affected limb, caused by nerve damage, can result in severe joint deformity and injuries. The major areas affected by sensory loss are the hands (especially the palms), feet (especially the soles) and eyes. The drug therapy offered to those with leprosy is efficacious and has low relapse rates. However, even with treatment, many with leprosy will go on to develop secondary damage to skin and limbs as the nerve damage sustained cannot be reversed. In some, treatment leads to inflammatory reactions in the nerves, sometimes resulting in further damage.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Leprosy remains a public health issue in poorer parts of the world. In 2007 there were approximately 255,000 new cases reported worldwide. Leprosy (or Hansen's disease) is a chronic infectious disease. The skin and peripheral nerves of people with leprosy contain leprosy bacteria. Leprosy can be cured with a combination of antibiotics. The immune system plays an important role in leprosy and determines if and how the disease will develop. The response of the immune system to the antigens of the leprosy bacteria may cause periods of inflammation in the skin and nerves, called reactions. Reactions are the main cause of acute nerve damage and disability in leprosy and occur in about one third of people with leprosy. One type of reaction is erythema nodosum leprosum (ENL), a serious and often chronic complication of leprosy caused by the immune system. People with ENL have red, painful swellings in the skin and often feel ill due to fever and general malaise. There are several treatments for ENL, including the oral drugs prednisolone, thalidomide, and clofazimine. We undertook a systematic review on this topic as it was not clear which treatments were most beneficial.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

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