## Classification & MDT Selection The clinical presentation — single lesion with sensory loss and low bacillary load (2+ on slit-skin smear) — is consistent with **paucibacillary (PB) leprosy**, specifically indeterminate or tuberculoid leprosy. ### WHO MDT Regimen for Paucibacillary Leprosy **Key Point:** PB leprosy (TT, BT, I) is treated with a **2-drug, 6-month MDT regimen**: - **Rifampicin** 600 mg monthly (supervised) + daily unsupervised - **Dapsone** 100 mg daily (unsupervised) Total duration: **6 months** with monthly supervised doses. ### Why This Regimen? | Aspect | Rationale | |--------|----------| | **Rifampicin** | Backbone of all MDT; most potent anti-leprosy agent; kills >99.9% of bacilli in first dose | | **Dapsone** | Bacteriostatic; prevents resistance; well-tolerated oral agent | | **Duration** | 6 months sufficient for PB (low bacillary load) | | **Clofazimine omitted** | Reserved for MB leprosy; prolongs therapy unnecessarily in PB | **High-Yield:** The distinction between PB (2-drug, 6 months) and MB (3-drug, 12 months) MDT is a **high-frequency NEET PG topic**. Bacillary load on slit-skin smear is the key discriminator. **Clinical Pearl:** Rifampicin renders the patient non-infectious within 2 weeks of starting MDT, allowing early return to normal activities and school/work. [cite:Park 26e Ch 8]
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.