scholarly journals Natural emergence of antigen-reactive T cells in lepromatous leprosy patients during erythema nodosum leprosum.

1985 ◽  
Vol 50 (3) ◽  
pp. 887-892 ◽  
Author(s):  
S Laal ◽  
L K Bhutani ◽  
I Nath
Keyword(s):  
T Cells ◽  
Erythema Nodosum ◽  
Lepromatous Leprosy ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients

Unusual non-trophic ulcerations in leprosy: A case series of 17 patients

2021 ◽  
pp. 004947552199849
Author(s):  
Prakriti Shukla ◽  
Kiran Preet Malhotra ◽  
Parul Verma ◽  
Swastika Suvirya ◽  
Abir Saraswat ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Case Series ◽  
Lepromatous Leprosy ◽  
Sweet Syndrome ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients ◽  
Atypical Presentations ◽  
Neuropathic Ulcers

Non-neuropathic ulcers in leprosy patients are infrequently seen, and atypical presentations are prone to misdiagnosis. We evaluated diagnosed cases of leprosy between January 2017 and January 2020 for the presence of cutaneous ulceration, Ridley–Jopling subtype of leprosy, reactions and histologic features of these ulcerations. Treatment was given as WHO recommended multi-bacillary multi-drug therapy. We found 17/386 leprosy patients with non-neuropathic ulcers. We describe three causes – spontaneous cutaneous ulceration in lepromatous leprosy (one nodular and one diffuse), lepra reactions (five patients with type 1; nine with type 2, further categorised into ulcerated Sweet syndrome-like who also had pseudoepitheliomatous hyperplasia, pustulo-necrotic and necrotic erythema nodosum leprosum) and Lucio phenomenon (one patient). Our series draws attention towards the different faces of non-neuropathic ulcers in leprosy, including some atypical and novel presentations.

scholarly journals Involvement of TNF-Producing CD8+ Effector Memory T Cells with Immunopathogenesis of Erythema Nodosum Leprosum in Leprosy Patients

2019 ◽  
Vol 100 (2) ◽  
pp. 377-385
Author(s):  
Pedro Henrique L. Silva ◽  
Luciana N. Santos ◽  
Mayara A. Mendes ◽  
José A. C. Nery ◽  
Euzenir N. Sarno ◽  
...  
Keyword(s):  
T Cells ◽  
Erythema Nodosum ◽  
Memory T Cells ◽  
Effector Memory ◽  
Effector Memory T Cells ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients

scholarly journals Dysregulation of IL-4 expression in lepromatous leprosy patients with and without erythema nodosum leprosum

2000 ◽  
Vol 71 ◽  
Author(s):  
I. NATH ◽  
N. VEMURI ◽  
A. L. REDDI ◽  
M. BHARADWAJ ◽  
P. BROOKS ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Lepromatous Leprosy ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients

scholarly journals Higher Treg FoxP3 and TGF-β mRNA Expression in Type 2 Reaction ENL (Erythema Nodosum Leprosum) Patients in Mycobacterium leprae Infection

2020 ◽  
Vol 14 (1) ◽  
pp. 304-309
Author(s):  
Luh Made Mas Rusyati ◽  
Mochammad Hatta ◽  
I Gede Raka Widiana ◽  
Made Swastika Adiguna ◽  
Made Wardana ◽  
...  
Keyword(s):  
Immune Response ◽  
T Cells ◽  
Mrna Expression ◽  
Erythema Nodosum ◽  
Mycobacterium Leprae ◽  
Healthy Controls ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients ◽  
The Mean

Background and Aim: The pathology of leprosy is determined by the host immune response to Mycobacterium leprae. Almost 40% of patients with leprosy undergo immune-mediated inflammatory episodes such as type 1 reactions and Erythema Nodosum Leprosum (ENL or type 2 reactions). Regulatory T (Treg) is a subset of T cells that are involved in the immune response. Treg cells express Forkhead Box P3 (FoxP3), which plays a role in suppressing the immune response. FoxP3 may work alongside Transforming Growth Factor Beta (TGF-β) to down-regulate T cells responses, leading to the antigen-specific anergy associated with leprosy, whereas ENL occurrs mostly in multibacillary leprosy patients. Based on that, the aim of our study was to analyze Treg FoxP3 and TGF-β mRNA expression in type 2 reactions ENL with Mycobacterium leprae infection. Methods: Forty-nine newly diagnosed multibacillary (MB) leprosy patients attending the Dermatovenereology Clinic of Leprosy Subdivision, Sanglah General Hospital, Denpasar, Indonesia, were included in the study. The study group consists of 25 leprosy patients with ENL and 24 non-ENL leprosy patients. Twenty-five patients were included in the study as healthy controls. In this study, Treg FoxP3 and TGF-β mRNA expressions were identified with the Real-time PCR method. Analysis of Variant (ANOVA), Chi-square test and odds ratio (OR) calculation were used; p<0.05 was considered statistically significant. Results: The result of this study showed that the mean of Treg FoxP3 mRNA expression was 13.3 ± 2.9 on ENL leprosy patients, 11.6 ± 4.1 on non-ENL, and 9.3 ± 1.2 on healthy controls. The mean of TGF-β mRNA expression was 11.7 ± 2.7 on ENL leprosy patients, 9.5 ± 3.6 on non-ENL, and 9.3 ± 1.2 in healthy patients. Statistical analysis for Treg FoxP3 and TGF-β mRNA level between ENL, non-ENL patients and healthy control group showed significance at p<0.05. Conclusion: From this study, it was concluded that higher Treg FoxP3 and TGF-β mRNA expressions were found in type 2 reaction ENL patients with Mycobacterium leprae infection. The role played by Treg FoxP3 and TGF-β in type 2 reaction episodes can possibly provide a new target for the treatment of this still-challenging complication of leprosy. Further studies are required to determine the involvement of other cytokines in type 2 reaction ENL patients.

Case Report: Rapid Response to Low-Dose Thalidomide in a Case of Severe Steroid Recalcitrant Erythema Nodosum Leprosum

2021 ◽  
Author(s):  
B. Savitha ◽  
Kabir Sardana ◽  
Ritu Kumari ◽  
Ananta Khurana ◽  
Surabhi Sinha ◽  
...  
Keyword(s):  
Low Dose ◽  
Erythema Nodosum ◽  
Lepromatous Leprosy ◽  
High Dose ◽  
Effective Treatment Option ◽  
Steroid Dependence ◽  
Erythema Nodosum Leprosum ◽  
Organ Specific ◽  
Inflammatory Drugs

Erythema nodosum leprosum (ENL), or type 2 lepra reaction, presents with crops of evanescent, tender erythematous nodules accompanied by fever, arthralgia, weight loss, malaise, and organ-specific manifestations, and is seen in borderline and lepromatous leprosy. The drugs approved for ENL include nonsteroidal anti-inflammatory drugs, systemic steroids, thalidomide, and clofazimine. The management of ENL is challenging because long-term steroid use leads to steroid dependence. Our patient had severe steroid recalcitrant ENL with vesicular and pustular lesions mimicking Sweet’s syndrome, and was treated effectively with a low-dose thalidomide regimen (100 mg/d) as opposed to the high dose (400 mg/d) recommended in the literature. We discuss the patho-mechanics and clinical utility of a low-dose thalidomide regimen as an effective treatment option for ENL.

scholarly journals A case of concomitant subcorneal pustular dermatosis and erythema nodosum leprosum in borderline lepromatous leprosy-relapses

2017 ◽  
Vol 4 (4) ◽  
pp. 6
Author(s):  
Hendra Gunawan ◽  
Nina Roslina ◽  
Oki Suwarsa
Keyword(s):  
Erythema Nodosum ◽  
Histopathological Examination ◽  
Lepromatous Leprosy ◽  
Erythema Nodosum Leprosum ◽  
Subcorneal Pustular Dermatosis ◽  
Morphological Index ◽  
The Face ◽  
History Of ◽  
Chronic Course ◽  
Bacterial Index

Subcorneal pustular dermatosis (SPD) is a rare, chronic, and recurrent pustular eruption characterized histopathologically by subcorneal pustules that contain neutrophils. SPD has been clearly reported conjunction with other diseases. Leprosy reactions are acute inflammatory process that immunologically driven on the chronic course of leprosy. Erythema nodosum leprosum (ENL) is a type II of leprosy reaction putatively can initiate SPD lesions. We report one case of concomitant SPD and ENL in borderline lepromatous leprosy-relapses. A 41-year-old man with the history of using multidrug therapy-multibacillary for leprosy presented with painful erythematous nodules on the trunk and extremities, accompanied by pustules on erythematous base on the face, arms, buttocks, and legs. There were thickening of both ulnar nerves with gloves and stocking hypesthesia. The bacterial index was 3+ and morphological index was 20\%. Histopathological examination on the pustule revealed subcorneal pustules with exocytosis of neutrophils which supported the diagnosis of SPD. A possible immunologic mechanism has been suggested in the induction of the occurence both SPD and ENL.

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