Erythema Nodosum Leprosum: Update and challenges on the treatment of a neglected condition

Acta Tropica
Perpétua do Socorro Silva CostaFernanda Sales Luiz Vianna

Abstract

Erythema Nodosum Leprosum (ENL) occurs due to the immunological complication of multibacillary leprosy and is characterized by painful nodules and systemic compromising. It is usually recurrent and/or chronic and has both physical and economic impact on the patient, being a very important cause of disability. In addition, ENL is a major health problem in countries where leprosy is endemic. Therefore, adequate control of this condition is important. The management of ENL aims to control acute inflammation and neuritis and prevent the onset of new episodes. However, all currently available treatment modalities have one or two drawbacks and are not effective for all patients. Corticosteroid is the anti-inflammatory of choice in ENL but may cause dependence, especially for chronic patients. Thalidomide has a rapid action but its use is limited due the teratogenicity and neurotoxicity. Clofazimine and pentoxifylline have slow action and have important adverse effects. Finally, there is no pattern or guidelines for treating these patients, becoming more difficult to evaluate and to control this condition. This review aims to show the main drugs used in the treatment of ENL and the challenges in the management of the reaction.

Citations

Sep 11, 2019·PLoS Neglected Tropical Diseases·Camila Oliveira da SilvaMaria Cristina Vidal Pessolani
May 3, 2019·Giornale Italiano Di Dermatologia E Venereologia : Organo Ufficiale, Società Italiana Di Dermatologia E Sifilografia·Sabha Mushtaq
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Jan 11, 2020·Frontiers in Immunology·Émilie Doz-DeblauweNathalie Winter
May 28, 2019·Pharmacogenomics·Perpétua do Socorro Silva CostaFernanda Sales Luiz Vianna
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