Reply to the Comments from Readers.

Thanks for your careful reading and priceless comments to our recent publication.[1] Although the incidence and prevalence of leprosy have declined significantly in recent decades, leprosy will probably persist as a major health problem in the world, especially in Southeast Asia. We are glad to see that our paper about multibacillary leprosy in a child can be noticed by the readers.

With regard to the first comment point, we agreed with them that early biopsy including Fite-Faraco stain is important in patients with only atypical cutaneous manifestations for diagnosis of multibacillary leprosy. Meanwhile, just as the reader pointed out, according to the WHO/multidrug therapy regimens [Table 1], standard child (ages 10–14 years) treatment regimen for multibacillary leprosy is consisted of dapsone 50 mg daily, rifampicin 450 mg monthly, clofazimine 50 mg every other day and 150 mg monthly for 12 months.[23] As the child in our report is 12 years old and the weight is 45 kg, we regulated clofazimine 200 mg monthly and 50 mg every other day and other drugs were the same as described above. Therefore, the treatment regimen resulted in partial remission of the cutaneous lesions within 2 months on the patient. Finally, we are very grateful to the reader for revising our confusing description for the treatment regimen.

Table 1

WHO’s multidrug therapy recommendations for multibacillary leprosy

Patients	Multibacillary leprosy (treatment for 12 months)
Adults	Dapsone 100 mg daily Rifampicin 600 mg monthly Clofazimine 50 mg daily and 300 mg monthly
Children (10–14-year-old) standard	Dapsone 50 mg daily Rifampicin 450 mg monthly Clofazimine 50 mg every other day and 150 mg monthly
Children (weighing 20–40 kg)	Dapsone 25 mg daily Rifampicin 300 mg monthly Clofazimine 50 mg twice weekly and 150 mg monthly
Children (weighing <20 kg)	Dapsone 2 mg/kg daily Rifampicin 10 mg/kg monthly Clofazimine 1 mg/kg daily and 6 mg/kg monthly

WHO: World Health Organization.

Although leprosy is highly valued in China, new cases in Guizhou Province have not been significantly reduced in the past 20 years. From 2008 to 2012, 1274 new patients were diagnosed in Guizhou Province, including 58 (4.6%) children (0–14 years old).[4] That indicates the active transmission of bacteria to a child from point sources. Therefore, we should pay more attention to leprosy in children.

Finally, we agree with the reader's comment that it is very necessary to find and treat the cases as early as possible. In China, each new case of leprosy will be registered and followed up by the Center for Disease Control and Prevention. As our reported case, the patient got referral to a native specialist for continued treatment and follow-up. The members of his family were screened in the Center for Leprosy Control and Prevention of Guizhou Province.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.