The recent World Health Organization multicentric field study on the treatment of paucibacillary (PB)
leprosy patients with single skin lesion (SSL) and a single dose of
rifampin-
ofloxacin-
minocycline (ROM) brought new hope to those who are engaged in the eradication of
leprosy from India. Being encouraged by the WHO report, we undertook the present hospital-based study and found that PB
leprosy patients with SSL were morphologically and histopathologically heterogeneous. The histological spectrum of SSL ranged from indeterminate through tuberculoid (TT) to
borderline tuberculoid (BT)
leprosy, and most patients had active BT
leprosy. Ninety new, untreated PB
leprosy patients with SSL were included in the present study for comparative assessment of the efficacies of ROM and ROM plus
Convit vaccine therapies. Children, pregnant women, lactating mothers and patients with any thickening of nerves were excluded. All patients were bacteriologically negative (skin-smear test) but
lepromin reactive. The patients were divided into two groups after proper matching for morphological and histological status of SSL: a) The test group included 60 patients and the control group included 30 patients. The test group was given a single dose of ROM initially and two
injections of low-dose
Convit vaccine, one initially and the other at the end of 3 months. b) The control group was given only a single dose of ROM initially. Both groups were followed clinically every 2 weeks for 6 months and retested for histological, bacteriological and
lepromin status at the end of 6 months. Thereafter, they were followed clinically every month for another 6 months. In the test group, the SSL resolved in 33.3%, regressed in 48.3%, and remained active in 18.3% of the patients, while the
granuloma disappeared in 70% of the cases. Only one patient developed
neuritis, and in another patient the disease relapsed on the eighth month. On the other hand, the SSL in the control patients resolved, regressed and remained active in 13.3%, 63.3% and 23.3% of the cases, respectively, while the
granuloma disappeared in 53.3% of the cases. In the seven patients who remained active, the disease course was progressive, and two of them developed
neuritis. The clinical outcome of the patients treated with ROM plus low-dose
Convit vaccine was statistically superior to those treated with single-dose ROM
therapy alone.