Reversal lepra reaction shown no response to :

D. i.e. Thalidomide Appearance of new skin lesions or signs of inflammation (e.g. redness and swelling etc.) in prevous lesions, neuritis (e.g. nerve pain) and low grade fever in borderline forms of leprosy suggest the diagnosis of Jopling's type I (delayed type IV hype/sensitivity) reaction. If type I lepra reaction preceeds the initiation of appropiate antimicrobial therapy it is k/a down grading reaction & the case becomes histologically more lepromatous. When it occurs after initiation of therapy, it is termed as reversal reaction & the case becomes more tuberculoid. - This is presentation of lepra reaction (type I - reversal) & in any case of lepra reaction antileprotic drug is not stopped. Thalidomide is ineffective and has no role in type I lepra (downgrading and reversal) reactionsQ.