Erythema Nodosum Leprosum and Thalidomide: How Effective?
Journal Title: Journal of Dermatology Research - Year 2023, Vol 4, Issue 2
Abstract
Erythema Nodosum Leprosum (ENL) is considered a distinct entity from the reaction state of leprosy, it is a complication observed during lepromatous leprosy, its occurrence before any antibacillary treatment is possible, but relatively rare in our practice [1]. Corticosteroid therapy is considered the reference treatment in almost all countries affected by this disease where thalidomide is not available. However, thalidomide offers an effective alternative to corticosteroid therapy, allows better long-term control and avoids the adverse effects of prolonged corticosteroid therapy [2]. We report a case of ENL in Lepromatous Leprosy (LL) resistant to conventional treatment then treated with thalidomide with good improvement. 29-year-old patient treated for lepromatous leprosy in October 2017 by polychemotherapy with poor treatment compliance, the patient was lost to sight for 8 months, consulted for a diffuse rash, progressing by flares for a year, calmed down by taking oral corticosteroids in an anarchic way. On examination, low grade fever was noted at 38°C, a diffuse nodular eruption on the extension faces of the forearms, thighs, legs, thorax and back painful on palpation independent of specific lepromatous lesions, hyperalgesic multineuritis with motor and sensory disorders in the lower limbs, bilateral gonoarthritis, bacterial conjunctivitis and orchiepididymitis.
Authors and Affiliations
Siham Boularbah, Hanane Baybay, Sabrina Oujdi, Zakia Douhi, Meryem Soughi, Mernissi Fatima Zahra
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