MDT and skin smears FAQ
Are skin smears a prerequisite for starting a patient on MDT?
No, skin smears are not a prerequisite for starting a patient on MDT. The clinical system of classification for the purpose of treatment includes the use of numbers of skin lesions and nerves involved as the basis for grouping the leprosy patients into MB and PB. If in doubt, the patient should be treated with MB regimen.
How often should skin smears be taken during and after the completion of MDT?
If reliable facilities for skin smears are available, then ideally all patients should have one examination at the start of treatment. This is to prevent an MB case being treated as PB. With fixed-duration treatment regimens, skin smears are not needed either to stop treatment or as a routine measure for follow-up of patients after completion of treatment.
In patients where clinical deterioration/relapse is suspected, skin smears should be taken from the most active sites. In view of the increasing prevalence of human immunodeficiency viruses (HIV) and hepatitis B infections in many countries where leprosy remains endemic, the number of skin-smear sites and the frequency of smear collection should be limited to a minimum.
It should be remembered that all skin-piercing procedures have the potential risk of transmitting HIV and hepatitis infections.