Erythema nodosum as Leprosy reaction

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Abstract

Purpose. To present a clinical case of leprosy exacerbation on the background of ongoing therapy.

Materials and methods. A 52-year-old patient with a diagnosis of "lepromatous (cutaneous) leprosy, leprosy LL" (multi-bacterial leprosy, lepromatous form, active stage), has an exacerbation in the form of nodular erythema at 3.5 years after the start of treatment. Due to the exacerbation of the leprosy process, dexamethasone therapy was performed intravenously in a dose of 4 mg/ml — 3.0 ml + 0.9% NaCl 200.0 ml daily No. 10.

Results. An exacerbation was diagnosed — leprosy nodular erythema. The prescription of adequate therapy led to a complete regression of clinical manifestations.

Conclusion. The described case is presented in connection with the rarity of this dermatosis.

About the authors

Viktoria G. Semenova

State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian Federation

Author for correspondence.
Email: v.g.semenova@mail.ru

Director, Sergiev Posad Branch of the State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian Federation

Russian Federation, Korolenko str., 3, bldg 6, Moscow

Ludmila L. Makarova

State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian Federation

Email: semenova@mail.ru

Head of the leprosy Department, Sergiev Posad Branch of the State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian Federation

Russian Federation, Korolenko str., 3, bldg 6, Moscow

Arfenya E. Karamova

State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian Federation

Email: semenova@mail.ru

Cand. Sci. (Med.), Head of the Dermatology Department, State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian Federation

Russian Federation, Korolenko str., 3, bldg 6, Moscow

References

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  2. Семенова В.Г., Карамова А.Э., Нефедова М.А., Чеботарев В.В., Земцов М.А., Одинец А.В., Шиханова Е.Н., Чумакова Е.С. Случай погранично-туберкулоидной лепры с атипичными и осложненными проявлениями. Вестник дерматологии и венерологии. 2019; 95 (4): 67—78. [Semenova V.G., Karamova A.E., Nefyodova M.A., Chebotarev V.V., Zemtsov M.A., Odinets A.V., Shikhanova E.N., Chumakova E.S. A case of borderline tuberculoid leprosy with atypical and complicated manifestations. Vestnik Dermatologii i Venerologii. 2019; 95 (4): 67—78. https://doi.org/10.25208/0042-4609-2019-95-4-67-78 (Russia).]
  3. Antunes D.E., Goulart I.M.B., Lima M.I.S., Alves P.T., Tavares P.C.B., Goulart L.R. Differential Expression of IFN-, IL-10, TLR1, and TLR2 and Their Potential Effects on Downgrading Leprosy Reaction and Erythema Nodosum Leprosum. J Immunol Res. 2019; 3405103. Published online 2019, Nov 7.
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  5. Costa P.D.S.S., Fraga L.R., Kowalski T.W., Daxbacher E.L.R., Schuler-Faccini L., Vianna F.S.L. Erythema Nodosum Leprosum: Update and challenges on the treatment of a neglected condition. Acta Trop. 2018; 183: 134—141.
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  7. Inamadar A.C., Adya K.A. The rash with painful and erythematous nodules. Clin Dermatol. 2019; 37 (2): 129—135.
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Supplementary files

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2. Fig. 1. Multiple brownish-pink maculas on the skin of the anterior abdomen surface

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3. Fig. 2. On the skin of the back, the plaques have a clarification in the center and erythematous borders on the periphery

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4. Fig. 3. Sparse hair in the area of the eyebrows from the lateral side

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5. Fig. 4. Diffuse infiltration of the forehead skin

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6. Fig. 5. There are bright red single nodes on the skin of the right forearm size, from 0.5 to 1.5 cm

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7. Fig. 6. There are bright red single nodes on the skin of the left elbow, size 0,5 × 0,5 cm

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8. Fig. 7. There are bright red single nodes on the skin of the right elbow, size 0,5 × 0,5 cm

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9. Fig. 8. There are bright red small nodes on the skin of the anterior surface of the thigh

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10. Fig. 9. There are bright red small nodes on the skin of the posterior surface of the thigh

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11. Fig. 10. Erythema of the facial skin

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12. Fig. 11. Erythematous rash on the skin of the neck

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Copyright (c) 2020 Semenova V.G., Makarova L.L., Karamova A.E.

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