Erythema nodosum leprosum (ENL) classically presents as tender, erythematous nodules over the face, arms and legs. Severe ENL can become vesicular or bullous and break-down and is termed erythema necroticans (Jopling & McDougall, 1996) and is treated with corticosteroids. The causes of death in a majority of leprosy patients are the same as in the general population, with the exception of renal damage in lepromatous leprosy. There is possible increased mortality from side-effects of antileprosy drugs, steroids, or other drugs used in reactions, from toxaemia in severe reactions, and from asphyxia due to glottic oedema (Jopling & McDougall, 1996). We report here a case of erythema necroticans, the cause of death being septicaemia, secondary to skin ulcers and urinary tract infection, precipitated by corticosteroids.
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Erythema nodosum leprosum necroticans: a case report of an atypical severe type 2 leprosy reaction and literature review.
Infez Med
June 2024
Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
Until now, leprosy remains a problem and challenge in the world because it can cause disability and morbidity in affected individuals, including problems due to the emergence of type 2 lepra reaction or erythema nodosum leprosum (ENL). The clinical picture of ENL can appear in an atypical and severe form, called ENL necroticans (ENN), which becomes a problem in diagnosis and therapy. We report a 17-year-old female with lepromatous leprosy and ENN who received therapy in the form of a combination of steroids and methotrexate.
View Article and Find Full Text PDF[Necrolytic migratory erythema in a patient with a glucagonoma].
Ned Tijdschr Geneeskd
October 2021
Amphia ziekenhuis, afd. Dermatologie, Breda.
This case concerns an 81-year-old man with weight loss and erythematosquamous plaques, with central clearing and atrophy. Due to a CT scan and blood test the diagnosis necrolytic migratory erythema as a paraneoplastic manifestation of glucagonoma was made. The pathogenesis is not completely elucidated.
View Article and Find Full Text PDFErythema necroticans.
QJM
September 2020
Department of Dermatology, Venereology, and Leprosy, R.G. Kar Medical College, Kolkata, West Bengal, India.
A retrospective study of the severe and uncommon variants of erythema nodosum leprosum at a tertiary health center in central India.
Int J Mycobacteriol
July 2019
Department of Pathology, Government Medical College, Nagpur, Maharashtra, India.
Background: Erythema nodosum leprosum (ENL) classically presents with tender, coppery, evanescent nodules along with constitutional features and visceral involvement. However, uncommon morphological variants of ENL-like erythema nodosum necroticans, erythema multiforme (EM)-like ENL, Sweet's syndrome (SS)-like ENL, Lucio phenomenon, and reactive perforating type of ENL have also been described in the literature. The primary objective of this study was to describe the clinical features of the severe and uncommon morphological variants of ENL.
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