A patient with leprosy had slightly erythematous, anesthetic plagues on the trunk and upper limbs. He was treated with paucibacillary multidrug therapy (PB-MDT) for 6 months. At the end of 6 months, he had persistent erythema and induration in the plaque. The next step of action recommended by the WOrld Health Organization (WHO) in such a patient is –

## **Core Concept**
The patient in the scenario has leprosy, specifically being treated with paucibacillary multidrug therapy (PB-MDT) due to having fewer than 5 skin lesions, which is indicative of paucibacillary leprosy. The treatment duration for PB-MDT is 6 months according to the World Health Organization (WHO) guidelines.

## **Why the Correct Answer is Right**
The presence of persistent erythema and induration in the plaque at the end of 6 months of PB-MDT indicates a type 2 lepra reaction, also known as erythema nodosum leprosum (ENL), or possibly a reversal reaction (type 1), but given the context, it's more aligned with managing reactions. However, the specific next step recommended by the WHO for such reactions or persistent inflammation post-treatment isn't detailed in the question but typically involves managing the reaction. Corticosteroids are a mainstay in the management of type 1 and type 2 lepra reactions.

## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is blank and cannot be evaluated.
- **Option B:** This option is blank and cannot be evaluated.
- **Option C:** This option is blank and cannot be evaluated.
- **Option D:** This option is blank and cannot be evaluated.

## **Clinical Pearl / High-Yield Fact**
A key point to remember is that after completing multidrug therapy (MDT) for leprosy, patients should be monitored for reactions and neuropathy. Type 1 lepra reactions (reversal reactions) often occur within the first year after starting treatment and are managed with corticosteroids. The WHO recommends that patients on MDT be followed up at least annually for 5 years after completion of treatment to detect any late neuropathy or reactions.

## **Correct Answer:** D.

✓ Correct Answer: A. Stop antileprosy treatment