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The treatment of leprosy may involve surgery, chemotherapy and physiotherapy. If a case is treated in the UK then advice from the panel of Leprosy Opinion should be sought. Multi-drug therapy is now essential because of developing drug resistance - now about 20% of cases are resistant to dapsone.

In 1982 the World Health Organisation recommended that lepromatous forms of the disease should be treated with daily Dapsone (100mg) in combination with rifampicin 600mg once monthly and clofazimine 50mg daily with an extra dose of 300mg once monthly. The monthly doses should be administered under supervision. This triple therapy should be given for a minimum of 2 years or continued skin smears are negative for acid-fast bacilli. In tuberculoid leprosy, rifampicin 600mg monthly - supervised administration - and dapsone 100mg daily for six months is recommended.

Vaccines against leprosy are presently being tested. The results from the trial of a vaccine based on M. leprae plus BCG did not show protection in the first survey conducted after 5 years. The results of trials with a further two vacccines are awaited.

For further details on the treatment of leprosy contact the Panel of Leprosy Opinion - details from DOH, telephone 0207 972 3272.

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