Abstract
BackgroundErythema nodosum leprosum (ENL) is a debilitating multisystem disorder which complicates leprosy. It is characterised by fever, malaise and painful erythematous cutaneous nodules. ENL is often recurrent or chronic in nature and frequently severe. Patients often require prolonged treatment with high doses of oral corticosteroids. There are no data on the mortality associated with treated ENL.MethodologyThe notes of patients who were admitted, discharged, transferred to another facility or died with a diagnosis of leprosy or a leprosy-related complication for a five year period were reviewed.Result/Discussion414 individuals were identified from the ward database. 312 (75.4%) patient records were located and reviewed. Ninety-nine individuals had ENL and 145 had a Type 1 reaction. The median age of individuals with ENLwas 25 years. Eight patients with erythema nodosum leprosum died compared with two diagnosed with Type 1 reaction. This difference is statistically significant (p = 0.0168, Fisher's Exact Test). There is a significant mortality and morbidity associated with ENL in this Ethiopian cohort. The adverse outcomes seen are largely attributable to the chronic administration of oral corticosteroids used to control the inflammatory and debilitating symptoms of the condition.
Highlights
Leprosy is a chronic granulomatous infection predominantly of the skin and peripheral nerves caused by Mycobacterium leprae [1]. 232, 857 new cases of leprosy were reported to the World Health Organization (WHO) in 2012 [2]
This study shows that in Ethiopia there is a significant mortality associated with Erythema nodosum leprosum (ENL)
This study provides additional evidence of the need for alternative agents to manage ENL when thalidomide is not available, contraindicated or unaffordable
Summary
Leprosy is a chronic granulomatous infection predominantly of the skin and peripheral nerves caused by Mycobacterium leprae [1]. 232, 857 new cases of leprosy were reported to the World Health Organization (WHO) in 2012 [2]. Leprosy is a chronic granulomatous infection predominantly of the skin and peripheral nerves caused by Mycobacterium leprae [1]. Leprosy reactions are important because they are the major cause of nerve function impairment which leads to leprosy associated disability and its life altering consequences. Type 1 reactions (T1R) affect patients with the borderline forms of leprosy causing inflammation in pre-existing leprosy skin lesions and neuritis [3]. Type 2 reactions or erythema nodosum leprosum (ENL) affect approximately 10% of those with borderline lepromatous (BL) leprosy and 50% of individuals with lepromatous leprosy (LL) [4]. Erythema nodosum leprosum (ENL) is a debilitating multisystem disorder which complicates leprosy. It is characterised by fever, malaise and painful erythematous cutaneous nodules. There are no data on the mortality associated with treated ENL
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
