Antileprotic Drugs

A 32-year-old man from rural Maharashtra presents with hypopigmented macules on his face and trunk for 6 months. Slit-skin smear shows 4+ acid-fast bacilli. He is started on multidrug therapy (MDT) for lepromatous leprosy. After 2 weeks of treatment with rifampicin, dapsone, and clofazimine, he develops acute hemolytic anemia with jaundice, dark urine, and reticulocytosis of 12%. His baseline G6PD status was not checked. Which antileprotic agent is most likely responsible for this adverse effect?

A 28-year-old woman with borderline tuberculoid leprosy (BT) is started on MDT (rifampicin, dapsone, clofazimine) for 12 months. After 3 months of therapy, she develops severe erythematous nodules, fever (38.5°C), and painful swelling of the left ulnar nerve. Her ESR is elevated at 95 mm/hr. Skin biopsy shows granulomatous inflammation with increased bacillary load in previously treated lesions. She has been compliant with treatment. What is the most likely diagnosis?

A 42-year-old woman from Tamil Nadu with lepromatous leprosy has completed 12 months of WHO multidrug therapy (MDT) with rifampicin, dapsone, and clofazimine. Skin smear microscopy now shows no acid-fast bacilli. She reports persistent brownish-black discoloration of skin and conjunctivae that developed during treatment. She is concerned about the cosmetic appearance. What is the most appropriate next step?

Which feature best distinguishes lepromatous leprosy (LL) from tuberculoid leprosy (TT) in terms of drug susceptibility and treatment duration?

A 38-year-old man from rural Maharashtra presents with hypopigmented macules on the face and trunk with loss of sensation. Slit-skin smear is positive for acid-fast bacilli (AFB). He is started on WHO multidrug therapy (MDT) for lepromatous leprosy. Regarding the adverse effects and drug interactions of antileprotic agents used in his regimen, all of the following are true EXCEPT: