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Multidrug therapy regimen for leprosy
Letters 1115
J AM ACAD DERMATOL VOLUME 55, NUMBER 6
4. Altman L. For science’s gatekeepers, a credibility gap. New York Times. May 2, 2006;Science Times section:1. 5. Journal of the American Academy of Dermatology. Information for authors. Available from: URL:http://www.journals. elsevierhealth.com/periodicals/ymjd/authorinfo. Accessed April 27, 2006. 6. McNutt RA, Evans AT, Fletcher RH, Fletcher SW. The effects of blinding on the quality of peer review: a randomized trial. JAMA 1990;263:1371-6. 7. Evans AT, McNutt RA, Fletcher SW, Fletcher RH. The characteristics of peer reviewers who produce good-quality reviews. J Gen Intern Med 1993;8:422-8. 8. Ross JS, Gross CP, Desai MM, Hong Y, Grant AO, Daniels SR, et al. Effect of blinded peer review on abstract acceptance. JAMA 2006;295:1675-80. 9. American Journal of Epidemiology. Instructions to authors. Available from: URL:http://www.oxfordjournals.org/our_journals/ aje/for_authors/general.html. Accessed April 27, 2006. 10. American Sociological Review. Instructions to authors. Available from: URL:http://www2.asanet.org/journals/asr/submission.html. Accessed April 27, 2006. 11. Journal of Adolescent Health. Instructions to authors. Available from: URL:http://www.elsevier.com/wps/find/journaldescription. cws_home/505765/authorinstructions. Accessed April 27, 2006. 12. Godlee F. Making reviewers visible: openness, accountability, and credit. JAMA 2002;287:2762-5. 13. Walsh E, Rooney M, Appleby L, Wilkinson G. Open peer review: a randomized controlled trial. Br J Psychiatry 2000;176:47-51. 14. BMJ. Our peer review process. Available from: URL:http://bmj. bmjjournals.com/advice/peer_review.shtml. Accessed April 27, 2006. 15. BMC dermatology publication and peer review processes. Available from: URL:http://www.biomedcentral.com/bmcdermatol/ ifora/#peerreview. Accessed April 27, 2006. 16. Jellinek NJ, Desousa RA, Bernhard JD. The clinical influence of the JAAD. J Am Acad Dermatol 2004;50:470-4. doi:10.1016/j.jaad.2006.05.015
Multidrug therapy regimen for leprosy To the Editor: In the April 2006 issue of the journal, Lupi et al1 provided a comprehensive and instructive review of the bacterial tropical diseases. In the last paragraph of the section on leprosy, they stated that ‘‘Leprosy is treated with a multidrug therapy regimen with a daily dose of dapsone (100 mg/d) and clofazimine (50 mg/d), plus a monthly controlled dose of rifampicin (300 mg).’’ The correct multidrug therapy regimen recommended by World Health Organization is dapsone (100 mg/d) plus a monthly controlled dose of rifampicin (600 mg) for 6 months in paucibacillary leprosy and dapsone (100 mg/d) and clofazimine (50 mg/d), plus a monthly controlled dose of rifampicin (600 mg) and clofazimine (300) mg for 24 months in multibacillary leprosy.2 I think this correction is necessary for this invaluable CME review. Alireza Firooz, MD Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences
Reprints and correspondence to: Alireza Firooz, MD, Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, 79 Taleghani Avenue, Tehran 14166, Iran. E-mail: [email protected] REFERENCES 1. Lupi O, Madkan V, Tyring SK. Tropical dermatology: bacterial tropical diseases. J Am Acad Dermatol 2006;54:559-78. 2. World Health Organization. Chemotherapy of leprosy for control programmes: technical report series 675. Geneva: World Health Organization; 1982. doi:10.1016/j.jaad.2006.07.022
Reply To the Editor: We thank Dr Firooz for pointing out the error in our review and for correctly stating the dosages of the multidrug therapy regimens for both paucibacillary and multibacillary leprosy. Omar Lupi, MD, PhD,a Vandana Madkan, MD,b and Stephen K. Tyring, MD, PhD, MBAc Department of Medical Clinics (Dermatology), Federal University of Rio de Janeiro and Instituto de Dermatologia da Santa Casa da Misericordia do Rio de Janeiro, Brazil;a and the Center for Clinical Studiesb and Departments of Dermatology and Internal Medicine,c University of Texas Health Science Center Reprint requests: Stephen K. Tyring, MD, PhD, MBA, Center for Clinical Studies, 2060 Space Park Dr, Suite 200, Houston, TX 77058. E-mail: [email protected] doi:10.1016/j.jaad.2006.08.020
Estrogen and the skin To the Editor: We read with interest the article by Hall and Phillips1 entitled ‘‘Estrogen and skin: The effects of estrogen, menopause, and hormone replacement therapy on the skin.’’ We would like to comment on the possible therapeutic benefit of estrogen for cutaneous autoimmune disease, and the discussion of risks involved with hormone replacement therapy (HRT) cited in this article. In a discussion of the effect of estrogens and the skin, it is important to comment on the potential immunologic effects of estrogen in autoimmune disease. In pregnancy, estrogen is thought to be responsible for the shift from Th1 to Th2 immunity that promotes fetal survival by decreasing Th1
J AM ACAD DERMATOL VOLUME 55, NUMBER 6
4. Altman L. For science’s gatekeepers, a credibility gap. New York Times. May 2, 2006;Science Times section:1. 5. Journal of the American Academy of Dermatology. Information for authors. Available from: URL:http://www.journals. elsevierhealth.com/periodicals/ymjd/authorinfo. Accessed April 27, 2006. 6. McNutt RA, Evans AT, Fletcher RH, Fletcher SW. The effects of blinding on the quality of peer review: a randomized trial. JAMA 1990;263:1371-6. 7. Evans AT, McNutt RA, Fletcher SW, Fletcher RH. The characteristics of peer reviewers who produce good-quality reviews. J Gen Intern Med 1993;8:422-8. 8. Ross JS, Gross CP, Desai MM, Hong Y, Grant AO, Daniels SR, et al. Effect of blinded peer review on abstract acceptance. JAMA 2006;295:1675-80. 9. American Journal of Epidemiology. Instructions to authors. Available from: URL:http://www.oxfordjournals.org/our_journals/ aje/for_authors/general.html. Accessed April 27, 2006. 10. American Sociological Review. Instructions to authors. Available from: URL:http://www2.asanet.org/journals/asr/submission.html. Accessed April 27, 2006. 11. Journal of Adolescent Health. Instructions to authors. Available from: URL:http://www.elsevier.com/wps/find/journaldescription. cws_home/505765/authorinstructions. Accessed April 27, 2006. 12. Godlee F. Making reviewers visible: openness, accountability, and credit. JAMA 2002;287:2762-5. 13. Walsh E, Rooney M, Appleby L, Wilkinson G. Open peer review: a randomized controlled trial. Br J Psychiatry 2000;176:47-51. 14. BMJ. Our peer review process. Available from: URL:http://bmj. bmjjournals.com/advice/peer_review.shtml. Accessed April 27, 2006. 15. BMC dermatology publication and peer review processes. Available from: URL:http://www.biomedcentral.com/bmcdermatol/ ifora/#peerreview. Accessed April 27, 2006. 16. Jellinek NJ, Desousa RA, Bernhard JD. The clinical influence of the JAAD. J Am Acad Dermatol 2004;50:470-4. doi:10.1016/j.jaad.2006.05.015
Multidrug therapy regimen for leprosy To the Editor: In the April 2006 issue of the journal, Lupi et al1 provided a comprehensive and instructive review of the bacterial tropical diseases. In the last paragraph of the section on leprosy, they stated that ‘‘Leprosy is treated with a multidrug therapy regimen with a daily dose of dapsone (100 mg/d) and clofazimine (50 mg/d), plus a monthly controlled dose of rifampicin (300 mg).’’ The correct multidrug therapy regimen recommended by World Health Organization is dapsone (100 mg/d) plus a monthly controlled dose of rifampicin (600 mg) for 6 months in paucibacillary leprosy and dapsone (100 mg/d) and clofazimine (50 mg/d), plus a monthly controlled dose of rifampicin (600 mg) and clofazimine (300) mg for 24 months in multibacillary leprosy.2 I think this correction is necessary for this invaluable CME review. Alireza Firooz, MD Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences
Reprints and correspondence to: Alireza Firooz, MD, Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, 79 Taleghani Avenue, Tehran 14166, Iran. E-mail: [email protected] REFERENCES 1. Lupi O, Madkan V, Tyring SK. Tropical dermatology: bacterial tropical diseases. J Am Acad Dermatol 2006;54:559-78. 2. World Health Organization. Chemotherapy of leprosy for control programmes: technical report series 675. Geneva: World Health Organization; 1982. doi:10.1016/j.jaad.2006.07.022
Reply To the Editor: We thank Dr Firooz for pointing out the error in our review and for correctly stating the dosages of the multidrug therapy regimens for both paucibacillary and multibacillary leprosy. Omar Lupi, MD, PhD,a Vandana Madkan, MD,b and Stephen K. Tyring, MD, PhD, MBAc Department of Medical Clinics (Dermatology), Federal University of Rio de Janeiro and Instituto de Dermatologia da Santa Casa da Misericordia do Rio de Janeiro, Brazil;a and the Center for Clinical Studiesb and Departments of Dermatology and Internal Medicine,c University of Texas Health Science Center Reprint requests: Stephen K. Tyring, MD, PhD, MBA, Center for Clinical Studies, 2060 Space Park Dr, Suite 200, Houston, TX 77058. E-mail: [email protected] doi:10.1016/j.jaad.2006.08.020
Estrogen and the skin To the Editor: We read with interest the article by Hall and Phillips1 entitled ‘‘Estrogen and skin: The effects of estrogen, menopause, and hormone replacement therapy on the skin.’’ We would like to comment on the possible therapeutic benefit of estrogen for cutaneous autoimmune disease, and the discussion of risks involved with hormone replacement therapy (HRT) cited in this article. In a discussion of the effect of estrogens and the skin, it is important to comment on the potential immunologic effects of estrogen in autoimmune disease. In pregnancy, estrogen is thought to be responsible for the shift from Th1 to Th2 immunity that promotes fetal survival by decreasing Th1