An uncommon variant of erythema nodosum leprosum responding well to methotrexate: Report of two cases

Abstract

Reactions in leprosy are acute inflammatory episodes that can be classified as type I or type II. Recognition and timely management of these patients is critical to avoid permanent disability. We present two cases of erythema nodosum leprosum, presenting with recurrent atypical features, responding well to a low dose of methotrexate.

Erythema nodosum leprosum necroticans: a case report of an atypical severe type 2 leprosy reaction and literature review

“…Several studies have reported alternative therapies for ENL, such as clofazimine, pentoxifylline, cyclosporine, azathioprine, etanercept, colchicine, chloroquine, minocycline, and zinc. However, the efficacies of these drugs were still varied [10,34].…”

Methotrexate in erythema nodosum leprosum: Pitfalls to avoid

“…We read with interest the short report by Rani et al entitled "An uncommon variant of erythema nodosum leprosum responding well to methotrexate: Report of two cases." 1 The authors describe two cases of erythema nodosum leprosum (ENL) with 'atypical features' and good response to low dose methotrexate. A closer examination of the report reveals several treatment concerns that hamper the prospect of drawing meaningful conclusions from this report.…”