Institute of Dermatology

Hello everyone! 

Today we went to the Institute of Dermatology in Bangkok. We had a lecture about Leprosy and about Mycoses, both taught to us by the same Dr. Kowit Kampirapap as yesterday. We learned that there are two different types of Leprosy, Tuberculoid and Lepromatous (which is the more progressive and severe disease). Tuberculoid Leprosy is easier to treat and is more likely to be self-limited by the body’s immune system. 

After we learned about leprosy, we had a lecture about Mycoses, which are fungal infections. Because of the tropical climate and how close Thailand is to the equator, they are prone to fungal infections. The infections we learned the most about are caused by fungal species that live in the soil and are generally transmitted by puncture wounds in the foot. They are most commonly seen in field workers because of this. 

After our lectures, we got to go sit with the medical students and see cases of skin infections. We got to see four cases of different fungal infections and five cases of Lepromatous Leprosy. It was interesting to see the cases of leprosy because they don’t look like what you would expect. It almost looks similar to cases of psoriasis, but this may be because they were all undergoing therapy and didn’t have active leprosy. The biggest distinguishing factor about the patients was that they almost all had hyperpigmentation from one of the medications, Clofazimine. Even though most Americans would like this side effect because we generally want to be tan, Thai people appreciate light skin, so some patients actually choose to get a less successful treatment because of this side effect. 

This is the back side of a blister pack treatment for one month for a patient with Lepromatous Leprosy. Notice that each day is numbered and the first day has its own special row. This is because you take one of the drugs only monthly and a second drug has a larger dose once monthly as compared to all of the other days. This type of blister pack ,ales it easier for patients to manage their medications. The Rifampicin causes red urine and flu like symptoms and is only taken on Day 1. The doctors use the patients complaints of these side effects to check for compliance of the medications. 

This is the front of the same blister pack as shown above. 

This is a blister pack for Tuberculoid Leprosy. This form of the disease is easier to treat, therefore only two drugs are needed, one of them again being once a month. 

As you can see in this picture, the treatment of leprosy is free for patients because the medications are donated by the World Health Organization (WHO). 

More updates to come tomorrow!