Mucous membrane pemphigoid

Introduction Identifying risk factors for leprosy reactions can preempt clinicians to initiate prompt treatment to prevent associated morbidities. Thus, a retrospective study was done to elucidate the risk factors among 44 newly diagnosed leprosy patients in Sarawak General Hospital from 1993 to 2007. Materials and methods Case folders were searched for demographic data, clinical characteristics, slit skin smear results, and the presence of type 1 leprosy reactions, its treatment and outcome. Analysis was done to determine the relative risks for development of this reaction. Student t test was used for comparison of means. The level of significance was set at 0.05. Results Type 1 reaction was seen in 25% (n=11) of patients. It occurred in 44.4% (n=4) of borderline lepromatous (BL), 33.3% (n=1) of mid borderline (BB), 37.5% (n=3) of borderline tuberculoid (BT) and 30% (n=3) of tuberculoid (TT) patients. Borderline spectrum of disease gave a relative risk of 2 (95% CI 0.3-0.9) and age of 40 gave a relative risk of 1.8 (95% CI 0.3-0.9) for the development of type 1 reaction. Older mean age (mean 53.7 years cf. 37.0 years, p = 0.01) and earlier presentation to health care workers (mean 5.8 months cf. 11.9 months, p = 0.02) was also significant risk factors Extent of disease and gender were not identified as risk factors. Conclusion Risk factors for type 1 leprosy reaction were borderline leprosy, older patients and shorter duration of illness on presentation.