{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:14:37Z","timestamp":1791836077351,"version":"4.3.4"},"reference-count":66,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Reaction in leprosy is an immune\u2010mediated acute inflammatory episodes that occur in the natural course of Hansen's disease. Reaction can occur before, during, or after starting multidrug therapy and is a major cause of nerve damage, morbidity, and disability in affected individuals. The aim of this review is to provide a comprehensive overview on the pathophysiology, clinical manifestations, and current management strategies for reactions in leprosy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative review of published literature was conducted focusing on the risk factors, immunopathogenesis, clinical presentation, severity scoring, diagnostic challenges, and therapeutic approaches of Type 1 (reversal reaction), Type 2 (Erythema Nodosum Leprosum), and Type 3 (Lucio phenomenon) leprosy reactions. Relevant studies, guidelines, and reviews were analyzed using the databases PubMed, Scopus, and Google Scholar from 2005 to 2025, to provide an updated synthesis of knowledge. The keywords used included: \u201cleprosy reactions\u201d, \u201ctype 1 reaction\u201d, \u201ctype 2 reaction\u201d, \u201clucio phenomenon\u201d, \u201cimmunopathogenesis\u201d, \u201cclinical presentation\u201d, \u201cseverity scoring\u201d, and \u201cmanagement\u201d. Articles were screened based on relevance to the topic and selected through consensus among the authors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Type 1 leprosy reaction is a delayed\u2010type hypersensitivity response due to enhanced cell\u2010mediated immunity, leading to the aggravation of pre\u2010existing skin lesions and neuritis. Type 2 reaction is an immune\u2010complex mediated phenomenon associated with systemic symptoms along with the fresh appearance of reddish subcutaneous nodules. Lucio phenomenon, which is due to endothelial cell injury, usually presents with tender purpura on the extremities which becomes necrotic and ulcerated. Management can be tailored according to the severity of the reactional episode.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Swift identification of leprosy reaction is important as it can be the first manifestation of leprosy in a large number of patients, and if not treated at an early stage, it may lead to deformity and disability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72519","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T04:41:54Z","timestamp":1779079314000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["\u201cReactions in Leprosy: Updated Insights Into Pathophysiology, Clinical Spectrum, and Therapeutic Approaches\u2014A Narrative Review\u201d"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0701-2018","authenticated-orcid":false,"given":"Bhaskar","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Dermatology Silchar Medical College Ghungoor India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7778-688X","authenticated-orcid":false,"given":"Manesha","family":"Singh","sequence":"additional","affiliation":[{"name":"Manesha Skin Care, Gayatri Nagar Motihari India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9615-1246","authenticated-orcid":false,"given":"Mohamad","family":"Goldust","sequence":"additional","affiliation":[{"name":"Department of Dermatology Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1719-3465","authenticated-orcid":false,"given":"Kinnor","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Dermatology Apollo Clinic Silchar Silchar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1258-4245","authenticated-orcid":false,"given":"Surajit","family":"Gorai","sequence":"additional","affiliation":[{"name":"Department of Dermatology Apollo Multispeciality Hospitals Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8549-625X","authenticated-orcid":false,"given":"Prajwal","family":"Pudasaini","sequence":"additional","affiliation":[{"name":"Department of Dermatology Civil Service Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7878-224X","authenticated-orcid":false,"given":"Seema","family":"Sitaula","sequence":"additional","affiliation":[{"name":"Department of Dermatology Institute of Medicine, Tribhuvan University Teaching Hospital Maharajgunj Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1330-6403","authenticated-orcid":false,"given":"Achyut","family":"Pokhrel","sequence":"additional","affiliation":[{"name":"Chitwan Skin Clinic Bharatpur Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9673-4656","authenticated-orcid":false,"given":"Esna","family":"Thapa","sequence":"additional","affiliation":[{"name":"Sahid Gangalal National Heart Centre Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-5247","authenticated-orcid":false,"given":"Sunil","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Department of Dermatology Chitwan Medical College Bharatpur Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"key":"e_1_2_17_2_1","volume-title":"Leprosy Reactions. 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