01763nas a2200313   4500000000100000008004100001260001300042653002800055653001000083653003000093653002000123653001000143653001100153653002900164653002400193653000900217653001700226653001500243100001100258700001500269700001100284700001400295245010600309856012000415300001100535490000700546520088200553022001401435       2009                            d  c2009 Aug10aAdministration, Topical10aChild10aDrug Therapy, Combination10aGlucocorticoids10aHaiti10aHumans10aImmunosuppressive Agents10aLeprosy, Borderline10aMale10aPrednisolone10aTacrolimus1 aSafa G1 aDarrieux L1 aCoic A1 aTisseau L00aType 1 leprosy reversal reaction treated with topical tacrolimus along with systemic corticosteroids.  uhttp://www.indianjmedsci.org/article.asp?issn=0019-5359;year=2009;volume=63;issue=8;spage=359;epage=362;aulast=Safa  a359-620 v633 a<p>An 11-year-old black Haitian boy presented with borderline lepromatous leprosy and was treated with rifampicin, dapsone, and clofazimine. After 4 months he developed a severe type 1 reversal reaction without nerve involvement. He was started on prednisolone (1 mg/kg daily). After 4 weeks of treatment with corticosteroids, his condition did not improve and the lesions remained painful. The patient was given a therapeutic trial with twice daily application of topical tacrolimus 0.1% ointment. The result was a dramatic improvement in the skin lesions. The patient's condition was maintained by topical tacrolimus therapy, with healing of all skin lesions. The prednisolone dose was then tapered to zero over a period of 12 weeks. To the best of our knowledge, this is the first report of the efficacy of topical tacrolimus in the treatment of type 1 leprosy reaction.</p>  a1998-3654