title: Erythema leprosum--after treatment of Lepromatous Leprosy.
abstract: Leprosy is usually well-controlled by multidrug therapy (MDT). However, in case of noncompliance or leprosy reactions, it may present a therapeutically challenge. A 33-year-old Brazilian woman with lepromatous leprosy was treated with MDT for one year, but then discontinued therapy because she wanted to have children. Eight weeks after stopping her medications, she developed a severe and recalcitrant erythema (nodosum) leprosum (ENL) which presented histologically with thrombosed small veins and neutrophilic inflammation in fat septa, but without arteritis. During her pregnancy and ensuing lactation period, glucocorticoids were the only suitable drug. With the use of the shortened WHO/MDT regimen (one year vs. two years of treatment), ENL will probably be seen more often after the end of leprosy therapy. It needs to be rapidly recognized and treated to avoid damage to eyes or kidneys.
authors.affiliation: Clinic for Dermatology, Münster University Hospital, Germany. mareike.eickelmann@ukmuenster.de
authors.forename: Mareike
authors.initials: M
authors.lastname: Eickelmann
authors.forename: Martin
authors.initials: M
authors.lastname: Steinhoff
authors.forename: Dieter
authors.initials: D
authors.lastname: Metze
authors.forename: Jane
authors.initials: J
authors.lastname: Tomimori-Yamashita
authors.forename: Cord
authors.initials: C
authors.lastname: Sunderkötter
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D004334:Drug Administration Schedule; D003875:Drug Eruptions / Q000188:drug therapy / Q000209:etiology; D004893:Erythema Nodosum / Q000139:chemically induced* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007917:Leprostatic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015440:Leprosy, Lepromatous / Q000150:complications / Q000188:drug therapy*; D055118:Medication Adherence; D011239:Prednisolone / Q000008:administration & dosage*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D016896:Treatment Outcome; D014376:Tuberculosis
chemical_list: D000893:Anti-Inflammatory Agents; D007917:Leprostatic Agents; D011239:Prednisolone