Two types of leprosy reaction are type 1, known as reversal reaction (RR), caused by acute changes in cellular immunity, and type 2 reaction known as
erythema nodosum leprosum (ENL), caused by humoral immunity process.3 Reversal reaction is associated with cell-mediated immunity (CMI) activities, consists of T helper cell-1 (Th1) and 2 (Th2).
Keywords:
Erythema Nodosum Leprosum; Leprosy; chronic fever.
Type II reaction without
erythema nodosum leprosum masquerading as lymphoma.
So, it can be concluded from the discussion that the
erythema nodosum leprosum presenting as vesiculopustuloulcerative lesions as initial manifestation of leprosy, although is very uncommon, can present as acute febrile illness manifesting as erythematous tender nodules and plaques over extremities, trunk, and other body parts.
Erythema nodosum leprosum is defined by the appearance of tender skin nodules that can be accompanied by fever, joint pain, bone tenderness, neuritis, edema, malaise, anorexia, and/or lym-phadenopathy (4).
The application has been submitted by Laphal of France, which is studying the compound for treatment of
erythema nodosum leprosum. Other applications that have also succeeded - and will therefore qualify for additional EU aid in their development under the Orphan Medicinal Products Regulation adopted in 2000 - include iloprost from Schering AG, for primary and certain secondary forms of pulmonary hypertension; anagrelide hydrochloride from Shire Pharmaceuticals of the UK, for essential thrombocytopenia; busulfan for Pierre Fabre of France, in hematopoeietic progenitor cell transplantation; nitisone from Swedish Orphan AB for tyrosinaemia; and ethyl eicosopentaenoate from Laxdale of the UK, for Huntingdon's Disease.
A decade later the drug was withdrawn from the market owing to its serious teratogenic potential and polyneuritis but was reintroduced after a few years to be used as a sedative for management of patients with
erythema nodosum leprosum (ENL).
Histopathology showed features of reversal reaction in 30% patients,
Erythema Nodosum Leprosum features in 64% patients and 6% showed both
Erythema Nodosum Leprosum and Erythema Nodosum Nercroticans features.
Erythema nodosum leprosum (ENL) is a severe, inflammatory, painful, multisystem complication of lepromatous leprosy.
His course was without complication by either reversal reaction or
erythema nodosum leprosum.
In infectious lesions, most common is leprosy with incidence of 22.67%,
erythema nodosum leprosum 20%, and cutaneous tuberculosis mostly scrofuloderma 8% and Prurigo Nodularis 6.67%.