How to Recognise and Manage Leprosy Reactions (ILEP learning by Paul Saunderson

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Helping people to prevent disability Responsibility for looking after the eyes, hands and feet lies principally with the person affected. Health workers may advise, help and encourage, but they cannot take over this task. Talk to each person individually as different people have different risk factors, depending on their life style and the work they do. qxd • • • • 1/5/03 9:29 am Page 44 The type of nerve damage they have. The symptoms of this damage. How they can tell when nerve damage is getting worse.

If a person detects a new injury such as a blister or a small wound, healing can be promoted by resting the affected limb for some days. Wounds should be kept clean using water and covering them with clean dressing or cloth. People with injuries should return to the clinic for further advice. Once a wound has healed, care must be taken to reduce the risks of it returning. Care of insensitive hands and feet Advice should include the care of insensitive hands and feet. • Hands and feet should be checked for damage and then soaked in water every day.

If sugar is found in the urine, serial blood sugar examinations must be made, firstly to establish the diagnosis and then to monitor the response to treatment. Insulin (by daily or twice daily injections) may be required in the first instance, but the condition usually resolves itself when steroids are stopped. Sputum-smear microscopy Testing urine for glucose Ulcers or osteomyelitis People with deep or dirty ulcers or osteomyelitis should be referred for septic surgery and antibiotics. Starting steroids before such treatment may lead to a worsening of the sepsis and more permanent damage, including the need for amputation.

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