{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:24:03Z","timestamp":1792715043245,"version":"4.5.0"},"reference-count":88,"publisher":"Scientific Scholar","content-domain":{"domain":["ijdvl.com"],"crossmark-restriction":true},"short-container-title":["IJDVL"],"abstract":"<jats:p>\n                    Leprosy, or Hansen\u2019s disease, caused by\n                    <jats:italic>Mycobacterium leprae<\/jats:italic>\n                    and\n                    <jats:italic>Mycobacterium lepromatosis<\/jats:italic>\n                    , is a chronic granulomatous infectious disease. Leprosy reactions, characterised by neurocutaneous inflammation, complicate the disease\u2019s indolent course, leading to significant morbidity. However, limited knowledge of reaction pathophysiology stems from a lack of experimental models and the abrupt onset of reactional episodes, posing challenges in delineating initial pathogenic steps. In type 1 reactions, ongoing studies explore the roles of interferon-gamma which results in increased interleukin (IL)-15 and autophagy. Leprosy reactions also exhibit an increase in T helper 17 (Th17) and a decrease in T-regulatory cell (Treg) populations, resulting in diminished tumour growth factor-beta and heightened IL-6 and IL-21 production. Exploring the pathogenesis of erythema nodosum leprosum (ENL) reveals insights into neutrophils, Toll-like receptor 9, B-cells, myeloid-derived suppressor cells, IL-10 pathway and neurotrophins. Noteworthy therapeutic targets include increased expression of cyclooxygenase 2 and vascular endothelial growth factor. Early reaction diagnosis is crucial to limit neural damage, with high-resolution ultrasonography showing promise in detecting minimal nerve involvement. Therapies for ENL management, such as thalidomide, methotrexate, apremilast, minocycline and tumour necrosis factor-alpha inhibitors, hold potential. This review addresses recent advances in leprosy reaction pathogenesis and diagnostics, offering therapeutic insights and preventive strategies to mitigate their onset.\n                  <\/jats:p>","DOI":"10.25259\/ijdvl_915_2024","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T07:03:47Z","timestamp":1735196627000},"page":"470-481","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Leprosy reactions: New knowledge on pathophysiology, diagnosis, treatment and prevention"],"prefix":"10.25259","volume":"91","author":[{"given":"Hitaishi","family":"Mehta","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sejal","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarun","family":"Narang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Dogra","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"10.25259\/IJDVL_915_2024\/ref-1","doi-asserted-by":"publisher","first-page":"372","DOI":"10.47276\/lr.79.4.372","article-title":"Leprosy type 1 (reversal) reactions and their management","volume":"79","author":"Walker","year":"2008","journal-title":"Lepr Rev"},{"key":"10.25259\/IJDVL_915_2024\/ref-2","doi-asserted-by":"publisher","first-page":"233","DOI":"10.3389\/fimmu.2017.00233","article-title":"A systematic review of immunological studies of erythema nodosum leprosum","volume":"8","author":"Polycarpou","year":"2017","journal-title":"Front Immunol"},{"key":"10.25259\/IJDVL_915_2024\/ref-3","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1016\/j.abd.2021.08.006","article-title":"Leprosy: Clinical and immunopathological characteristics","volume":"97","author":"Froes","year":"2022","journal-title":"An Bras 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