title: Erythema nodosum leprosum associated with minocycline.
abstract: Erythema nodosum leprosum is defined by the appearance of tender skin nodules, which can be accompanied by fever, joint pain, neuritis, edema, malaise and/or lymphadenopathy. The authors describe the case of a 19-year-old Angolan black woman, resident in Portugal for the last 10 years, diagnosed with Hansen's disease at the age of 12, irregular with follow-up and non-compliant with treatment. She was referred to our clinic with painful nodules and pustules on the upper limbs, diffuse facial infiltration with pustules and fever, after initiating minocycline with the intention of treating acne. Diagnosis of erythema nodosum leprosum was confirmed by the presence of acid-fast bacilli in the skin smear and also in skin biopsy. Minocycline was suspended and the patient was treated with systemic steroids, with prompt clinical improvement. Our case is reported to alert clinicians to this unusual presentation of erythema nodosum leprosum in a patient treated with highly bactericidal drugs that were not intended to treat Hansen's disease.
authors.affiliation: Clínica Universitária de Dermatologia, Hospital de Santa Maria (CHLN), Avenida Prof. Egas Moniz, 1649-035 Lisboa, Portugal. ritatravassos@gmail.com
authors.forename: Ana Rita
authors.initials: AR
authors.lastname: Travassos
authors.forename: Joana
authors.initials: J
authors.lastname: Antunes
authors.forename: David
authors.initials: D
authors.lastname: Pacheco
authors.forename: Luís Soares
authors.initials: LS
authors.lastname: Almeida
authors.forename: Paulo
authors.initials: P
authors.lastname: Filipe
authors.forename: Manuel Sacramento
authors.initials: MS
authors.lastname: Marques
mesh_terms: D000152:Acne Vulgaris / Q000175:diagnosis / Q000188:drug therapy; D001707:Biopsy, Needle; D004359:Drug Therapy, Combination; D004893:Erythema Nodosum / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007917:Leprostatic Agents / Q000627:therapeutic use*; D015440:Leprosy, Lepromatous / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D008911:Minocycline / Q000009:adverse effects* / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007917:Leprostatic Agents; D011239:Prednisolone; D008911:Minocycline