02461nas a2200373   4500000000100000008004100001260001300042653001000055653001100065653002100076653001200097653003700109653003300146653001100179653001100190653002000201653002300221653002500244653001300269653003000282653003300312653001400345653004000359653001300399653000900412100001200421700001200433700001800445245010300463300001100566490000700577520148900584022001402073       1996                            d  c1996 Mar10aAdult10aBiopsy10aCesarean Section10aDapsone10aDose-Response Relationship, Drug10aDrug Administration Schedule10aFemale10aHumans10aInfant, Newborn10aLeprostatic Agents10aLeprosy, Tuberculoid10aPlacenta10apolymerase chain reaction10aPractice Guidelines as Topic10aPregnancy10aPregnancy Complications, Infectious10aRifampin10aSkin1 aNeuer A1 aSpang E1 aSticht-Groh V00a[Initial manifestation of tuberculoid leprosy in pregnancy. Guidelines for diagnosis and therapy].  a156-600 v563 a<p>Pregnancy has long been associated with the first presentation of clinical leprosy or aggravation of the existing disease. In Germany leprosy has been diagnosed in 107 patients since 1980. A 27-year-old Singhalese female, gravida 2 at 14 weeks' gestation was admitted with well defined, elevated, erythematous lesions on her cheeks and nose. Clinical examination revealed central anaesthesia in the lesions. No further signs of leprosy in the skin, the mucosae and the peripheral nerves were found. Fite-Faraco staining of the skin biopsy showed sporadic acid-fast bacilli and confirmed an active subpolar tuberculoid leprosy (TTs). Outpatient treatment was immediately initiated with oral rifampin 600 mg monthly and dapsone 100 mg daily. During the 4-month treatment cycle the skin lesions vanished completely. Additional leprosy reactions did not occur and the medication was well tolerated. However, in the 32nd gestational week the patient was readmitted with premature labour and 3 weeks later Caesarean section was performed because of cardiotocographic pathology. Polymerase chain reaction (PCR) for M. leprae of placental tissue was negative. Antibodies against phenolic glycolipid 1 (PGL 1) of M. leprae (IgM-Elisa and Dot-Elisa) from cord blood, maternal and newborn blood were not found. On the fifth postpartal day the healthy mother and her baby were discharged. In conclusion, leprosy in pregnancy can be treated safely and successfully by combined drug therapy.</p>  a0016-5751