The coronavirus disease 2019 (COVID-19) pandemic has led to governments implementing a variety of public health measures to control transmission and has affected health services. Leprosy is a communicable neglected tropical disease caused by Mycobacterium leprae and is an important health problem in low- and middle-income countries. The natural history of leprosy means that affected individuals need long-term follow-up. The measures recommended to reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can create barriers to health services. We evaluated the impact of the COVID-19 epidemic response on leprosy services and disease management. We conducted a cross-sectional online survey with healthcare professionals in leprosy referral centres. Eighty percent of leprosy diagnostic services were reduced. All respondents reported that multidrug therapy (MDT) was available but two reported a reduced stock. Clinicians used alternative strategies such as telephone consultations to maintain contact with patients. However, patients were not able to travel to the referral centres. This study highlights the effects of the initial phase of the SARS-CoV-2 pandemic on leprosy services in a range of leprosy-endemic countries. Many services remained open, providing leprosy diagnosis, MDT and leprosy reaction medications. Centres developed innovative measures to counter the negative impacts of the COVID-19 pandemic.

Erythema nodosum leprosum (ENL) is an acute immune complex-mediated condition of the dermis, subcutaneous tissue, and other tissues seen in patients with multibacillary (MB) leprosy, causing severe impairment to patients’ quality of life. To date, there is no standard diagnostic criteria for ENL. We aimed to study the diagnostic value and accuracy of Neutrophil-to-Lymphocyte ratio (NLR), Lymphocyte-to-Monocyte ratio (LMR), and Platelet-to-Lymphocyte ratio (PLR) in diagnosing ENL. This is an analytic retrospective study with a cross-sectional design that describes the distribution and clinical characteristics of all newly diagnosed MB patients of Dr. Soetomo General Hospital Surabaya in the years 2018–2020. NLR, LMR, and PLR were calculated for all patients, and a receiver operating characteristic curve (ROC) was generated to identify the cut-off points. Among a total of 182 patients with MB leprosy, 22 cases (12.09%) were reported with ENL. WBC, neutrophils, monocytes, and thrombocytes showed a positive correlation with the incidence of ENL, but not lymphocytes. The NLR cut-off point for the diagnosis of ENL was 4.99 (sensitivity 86.4%, specificity 82.5%, accuracy 82.97), while that of PLR was 237.46 (sensitivity 63.6%, specificity 73.1%, accuracy 71.98%). LMR had poor sensitivity and specificity levels of 50% and 28.7%, with cut-off point of 2.28 and accuracy of 31.32%. These results suggest that NLR and PLR could be potential biomarkers for the diagnosis of ENL.

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which tends to attack peripheral nerves and skin. The diagnosis of leprosy is based on the presence of one of three cardinal signs. Early diagnosis of leprosy is critical and is made through clinical examination and investigation. Purpose: To discuss the diagnosis, laboratory examination, and treatment of leprosy, considering that early diagnosis and appropriate treatment are the key elements in breaking the chain of transmission and preventing leprosy patients' disabilities. Review: Leprosy is a chronic granulomatous infectious disease caused by the Mycobacterium leprae. Based on clinical appearance, histopathology findings, and immunological, leprosy is grouped into six forms using the Ridley-Jopling classification, namely Tuberculoid (TT), Borderline Tuberculoid (BT), Borderline-borderline Mid-borderline (BB), Borderline-lepromatous (BL), Subpolar Lepromatous (LLs), and Polar Lepromatous (LLp). Based on the treatment category, leprosy is grouped into paucibacillary (PB) and multibacillary (MB). Leprosy is often diagnosed clinically, and skin scraping smear remains the preferred laboratory method. The negative results of smear skin scraping may not necessarily exclude leprosy. Therefore, a higher sensitivity test might be needed to detect M. leprae. Treatment with Multi-Drug Therapy (MDT) is adjusted based on the type of leprosy, whether it belongs to the PB or MB group. Treatment of PB type, regimens are rifampicin and dapsone, while in MB type, the patients received rifampicin, dapsone, and clofazimine regimens. Conclusion: A proper diagnosis for leprosy, both through physical examination and laboratory examination, is required to determine an effective MDT treatment and break the chain of disease transmission.

Intoduction: Psychological strength plays an important role in reducing stress due to leprosy because leprosy can cause physical, psychological, and social problems. For that reason, this study aims to investigate the relationship between coping sources, coping strategies, and psychological well-being through leprosy stress. Methods: This research instrument uses a stress perception scale, coping sources, coping strategies, and psychological well-being scale to collect data from 125 participants consisting of women (33.60%) and men 66.40%. The test analysis in this study uses SmartPLS through structural equation modeling to prove the correlation. Results: The results of the SEM test indicate that there is a negative relationship between coping resources and leprosy stress, with a coefficient value of (− 0.380), p-value of (0.000) < 0.05, and a positive relationship is obtained with psychological well-being with the coefficient value of (0.427), p-value of (0.000) < 0.05. Meanwhile, the SEM test shows a negative relationship between coping strategies and stress of leprosy, with the coefficient of (− 0.566), p-value of (0.000) < 0.05, and a positive relationship is obtained with psychological well-being (0.355), p-value of (0.000) < 0.05. Furthermore, on psychological well-being, stress shows a negative relationship, with the coefficient of (− 0.212), p-value of (0.002). Discussion: Exploration of important coping sources is done to weaken the power of leprosy as a stressor and the use of effective coping strategies is needed to solve physical, psychological, and social problems for “People Affected by Leprosy”, and simultaneously these two attributes are used to achieve prosperity. psychological. better.

Background: The disability in leprosy is caused by M. leprae invasion and infiltration into the skin and the mucous membrane that results in nerve damage and deformities, loss of sensation, paralysis, and ocular manifestation. The risk of disability can be influenced by several factors, including the type of leprosy, disease duration, the number of nerves affected, leprosy reactions, gender, age, type of treatment, socioeconomic factors, and leprosy case detection methods. This study aimed to evaluate the risk factor of disability in leprosy patients. Methods: It was a cross-sectional retrospective analytical study to discover the correlation between risk factors with the grade of disability in leprosy patients who were treated in Dermatovenerology Outpatient Clinic Dr. Soetomo General Hospital Surabaya from 2017 to 2019. Result: This study found a total of 275 leprosy patients with disabilities, consisting of 76 patients (27,6%) with grade-1 disability and 199 patients (72,4%) with grade 2 disability. There was a statistically significant correlation between age (p=0,025), duration of disease (p=0,001), and multidrug therapy (MDT) history (p=0,001) with the incidence of disability. Gender, bacterial index, type of leprosy, and leprosy reaction were not significantly related to disability. Conclusion: This study showed that age, duration of disease, and the history of MDT treatment were related to the incidence of disability. The longer the disease's duration despite the patient having received MDT, the more risk of the patient having a disability.

Striae distensae (SD) are linear scar tissue in the dermis that arises from stretching the skin. There are two types of SD, striae rubrae and striae albae (SA) which is marked with a line hypopigmentation that cause a psychological problem, especially in the high skin type. The standard therapy is a 0.1% tretinoin cream, but it takes a long time to reach the collagen so it needs invasive measures to reach these targets. This study was comparing 0.1% tretinoin cream with combination therapy of fractional microneedle radiofrequency (FMR) and fractional CO₂ laser for SA. The number of subjects in this study was 11 patients each group with Fitzpatrick skin types IV or V. Biopsy was taken before and after therapy. The clinical changes in SA lesions in this study were represented by measurements of the length and width. The percentage of collagen area is the amount of collagen fibers with Masson’s trichrome staining. The clinical changes of lesion in the combination therapy decreased. The percentage change in collagen area in the combination therapy group had a higher increase. The side effect experienced by all combination group subjects was postinflammatory hyperpigmentation, two subjects in 0.1% tretinoin cream group experienced irritation.