| Autor: |
Petiot A; Dermatology Department, Cayenne Hospital Centre, Cayenne, French Guiana., Drak Alsibai K; Histopathology and Cytology Department, Cayenne Hospital Centre, Cayenne, French Guiana., Dossou C; Dermatology Department, Cayenne Hospital Centre, Cayenne, French Guiana., Couppie P; Dermatology Department, Cayenne Hospital Centre, Cayenne, French Guiana., Blaizot R; Dermatology Department, Cayenne Hospital Centre, Cayenne, French Guiana. blaizot.romain@gmail.com. |
| Abstrakt: |
A resurgence of leprosy as a public health problem in French Guiana was reported over the period 2007 to 2014, particularly among Brazilians gold miners. Prolonged multidrug therapy and reversal reactions represent a therapeutic challenge. The objective of this study was to assess the evolution of leprosy in this European overseas territory. All patients with leprosy confirmed in histopathology between 1 January 2015 and 31 December 2021 were included. A total of 86 patients were included, including 64 new cases and 22 previously diagnosed cases. Sixty patients (70%) were male, 6 cases were paediatric. Brazilian gold miners represented 44.1% of reported occupations (15/34). Maroons represented the second community (13 patients, 15%). Multibacillary and paucibacillary forms were found in 53 (71%) and 22 (29%) patients, respectively. The annual prevalence never exceeded the threshold of 1/10,000. The mean incidence and prevalence were significantly lower than during the period 2007 to 2014 (p < 0.0001). Reversal reactions were found in 29 patients and almost always required a long course of steroids. Infliximab allowed a reduction in the length of treatment with steroids in 2/2 cases. In conclusion, the prevalence of leprosy has decreased significantly in French Guiana, but remains driven by the population of illegal gold miners. Anti-tumour necrosis factor (anti-TNF) drugs represent a promising option in the management of reversal reactions. |
