A known leprosy patient develops multiple tender erythematous nodules over the limbs with fever and joint pains. Skin smears remain positive. Which drug is the specific treatment of choice for this complication?
- A Prednisolone
- B Clofazimine
- C Thalidomide ✓
- D Aspirin
Correct answer: C. Thalidomide
Explanation
This is erythema nodosum leprosum (type 2 lepra reaction), an immune complex mediated reaction occurring in multibacillary disease. Thalidomide is the treatment of choice, acting through suppression of TNF-alpha production. Its severe teratogenicity restricts use strictly to non-pregnant patients of reproductive age, where corticosteroids are preferred. Prednisolone is the drug of choice for type 1 (reversal) reactions instead.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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