scholarly journals Pathogenesis of bullous erythema nodosum leprosum: a case report

2020 ◽  
Vol 8 (12) ◽  
pp. 4509
Author(s):  
Navdeep Kaur
Keyword(s):  
Case Report ◽  
Erythema Nodosum ◽  
Acute Onset ◽  
Acid Fast Bacilli ◽  
Smear Examination ◽  
Dermatological Examination ◽  
Erythema Nodosum Leprosum ◽  
Different Parts ◽  
Body Ache

A 54 years old male, presented with acute onset of fever, malaise and body ache and multiple painful reddish swellings and fluid filled lesions in different parts of body. He gave history suggestive of several earlier episodes of type 2 lepra reactions with erythema nodosum leprosum lesions which were managed with corticosteroids. Dermatological examination revealed multiple erythematous tender nodules and plaques on face, extremities and trunk. He also had multiple bullous lesions on trunk. Investigations revealed polymorphonuclear leukocytosis and raised ESR. Biochemical investigations were normal. Slit skin smear examination showed fragmented acid fast bacilli with bacteriological index of 5+.

Cutaneous ulceration as a presenting feature of type 1 lepra reaction: A case report

2022 ◽  
pp. 004947552110686
Author(s):  
Pallavi Hegde ◽  
Deepti Jaiswal ◽  
Varsha M Shetty ◽  
Kanthilatha Pai ◽  
Raghavendra Rao
Keyword(s):  
Case Report ◽  
Erythema Nodosum ◽  
Immunological Response ◽  
Lepromatous Leprosy ◽  
Multidrug Therapy ◽  
Cutaneous Lesions ◽  
Erythema Nodosum Leprosum

Reactions in leprosy represent sudden shift in the immunological response and are seen in 11–25% of affected patients. It can be seen before, during or after the completion of multidrug therapy (MDT). 1 Two types of reactions are recognized; Type 1 reaction (T1R), seen in borderline leprosy, affecting mainly skin and nerves; type 2 reaction (T2R) or erythema nodosum leprosum (ENL), seen in lepromatous leprosy, characterized by systemic features in addition to cutaneous lesions. Trophic ulcers and ulcerating ENL are well known entities while cutaneous ulceration in T1R is extremely rare; we describe an immune-competent woman with cutaneous ulceration as a presenting feature to highlight the need to recognize this entity at the earliest opportunity.

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.

Bullous erythema nodosum leprosum (bullous type 2 reaction)

2002 ◽  
Vol 41 (6) ◽  
pp. 362-364 ◽  
Author(s):  
Gomathy Sethuraman ◽  
Divakaran Jeevan ◽  
Chakravarthy Rangachary Srinivas ◽  
Gopal Ramu
Keyword(s):  
Erythema Nodosum ◽  
Erythema Nodosum Leprosum

scholarly journals Lucio Phenomenon mimicking with Vasculo necrotic Erithema Nodosum Leprosum: A Case Report

2020 ◽  
Vol 13 (3) ◽  
pp. 288-294
Author(s):  
Dwi Sepfourteen ◽  
Tutty Ariani
Keyword(s):  
Endothelial Cell ◽  
Erythema Nodosum ◽  
Lepromatous Leprosy ◽  
Lower Limbs ◽  
Acid Fast Bacilli ◽  
Erythema Nodosum Leprosum ◽  
Endothelial Proliferation ◽  
Hands And Feet ◽  
Epidermal Necrosis ◽  
Lucio’S Phenomenon

Clinical features of Lucio’s phenomenon (LP), shows a nectorizing erythema, may mimicking Erythema Nodosum leprosum with vasculonecrotic. A 46 years old man presented with diagnosis lepromatous leprosy with Lucio’s phenomenon and diferential diagnosis borderline lepromatous (BL) with vasculonecrotic erithema nodosum leprosum. The patients complained there were painless ulcers on his lower limbs and scrotum, with surrounded by purpuric patches which subsequently became gangrenes and ulcerated for 3 weeks. There was numbness of both hands and feet, the eyelashes, eyebrows baldness since 5 years ago. Patient never got the treatment before. Bacteriological examination showed bacterial index 6+ Histopathology: there were Flattened epidermis by narrow grenz zone, and lymphocyte in perivascular with macrophage. There was endothelial proliferation of capiller. Fite faraco stain showed macrophage infiltration around the perivasculer, with colonization of the endothelial cell by acid fast bacilli and epidermal necrosis and diagnosis as Lepromatous leprosy with Lucio phenomenon. This patient is given adult multiple drug therapy (MDT) therapy, methylprednisolone, neurotrophic vitamins. Lucio’s phenomenon most commonly affects patients with untreated leprosy. Clinically, it may be difficult to differentiate Lucio phenomenon from Erythema nodosum leprosum with vasculonecrotic. In this case, the histopathological examination were colonization of endothelial cell by acid fast bacilli, epidermal necrosis and endothelial proliferation of the vessel.

scholarly journals ERYTHEMA NODOSUM LEPROSUM- A CASE REPORT.

2012 ◽  
Vol 1 (6) ◽  
pp. 1015-1018
Author(s):  
Pragnya Paramita Panda ◽  
Lenka P. R. ◽  
Panigrahi K ◽  
Pattnaik D
Keyword(s):  
Case Report ◽  
Erythema Nodosum ◽  
Erythema Nodosum Leprosum

scholarly journals Erythema Nodosum Leprosum Triggered by Antecedent Influenza Vaccine and Respiratory Tract Infection: A Case Report

2018 ◽  
Vol 23 (1) ◽  
pp. 114-116 ◽  
Author(s):  
Matthew K. Sandre ◽  
Sonia M. Poenaru ◽  
Andrea K. Boggild
Keyword(s):  
Case Report ◽  
Tract Infection ◽  
Influenza Vaccine ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Erythema Nodosum ◽  
Upper Respiratory Tract ◽  
Erythema Nodosum Leprosum ◽  
Upper Respiratory ◽  
New Onset

We present a patient with new-onset erythema nodosum leprosum months after successful treatment of her mid-borderline leprosy, which was likely triggered by a combination of antecedent influenza vaccination and upper respiratory tract infection.

Canadian Case Report of Erythema Nodosum Leprosum Successfully Treated with Prednisone and Thalidomide

2010 ◽  
Vol 14 (2) ◽  
pp. 95-99 ◽  
Author(s):  
Mélissa Saber ◽  
Caroline Bourassa-Fulop ◽  
Danielle Bouffard ◽  
Nathalie Provost
Keyword(s):  
Case Report ◽  
Erythema Nodosum ◽  
Term Treatment ◽  
Response To Treatment ◽  
Cutaneous Lesions ◽  
Erythema Nodosum Leprosum ◽  
Long Term Treatment ◽  
The Face ◽  
Systemic Symptoms

Background: Erythema nodosum leprosum (ENL) is a disease rarely encountered in Canada. It is characterized by multiple remissions and recurrences, often requires long-term treatment, and can result in debilitating sequelae. Objective: To promote rapid recognition and adequate therapy for ENL. Methods: Case report of a 39-year-old man diagnosed with an ENL. The clinical and histopathologic features, treatment provided, and response to treatment are detailed in this article. Results: ENL presented itself as painful cutaneous lesions on the face and limbs, bilateral paresthesia of the fourth and fifth fingers, and systemic symptoms. Prednisone 40 mg daily for a week and then 60 mg daily for another week reduced the lesions by 80% and the pain by 50%. Although prednisone 60 mg daily was continued for one more week and then stopped, thalidomide was started at a dose of 300 mg daily for 4 weeks and then reduced gradually, which led to complete resolution. Conclusion: At the 7½-month follow-up, the patient remained completely asymptomatic.

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