Erythema nodosum leprosum presenting as sweet's syndrome-like reaction in a borderline lepromatous leprosy patient

Suryawati, Nyoman; Saputra, Herman

doi:10.4103/ijmy.ijmy_49_18

Cited by 9 publications

(11 citation statements)

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“…Atypical ENL lesions were predominant in male patients with an approximate male to female ratio of 2.7 : 1 and an age range of 10–73 years with a mean ± standard deviation (SD) of 41.5 ± 44.5. A list of reported cases of atypical ENL is demonstrated in Table 1 [4–59].…”

Section: Resultsmentioning

confidence: 99%

Atypical presentations of erythema nodosum leprosum: Diagnostic and therapeutic aspects

Alakad

Nofal

Assaf

2021

J Deutsche Derma Gesell

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Summary Classic erythema nodosum leprosum (ENL) is characterized clinically by abrupt eruption of tender erythematous nodules, papules and plaques. Variable atypical patterns have been described, for example pustular, bullous, ulcerative, necrotic and Sweet’s syndrome‐like ENL. We aim to review previously reported cases of atypical ENL addressing the diagnostic and therapeutic aspects of these uncommon presentations. A search of medical literature for all cases of atypical ENL was conducted in the PubMed database till 2020. Data of patients with atypical ENL were collected and analyzed to describe the epidemiological, clinico‐histological and therapeutic features. The major five clinically described presentations of atypical ENL include vesiculo‐bullous lesions (46 % of patients), ulcero‐necrotic lesions (41 %), erythema multiforme‐like lesions (28 %), Sweet’s syndrome‐like lesions (11 %) and pustules (9 %). The skin lesions were accompanied by fever and constitutional symptoms in all patients. Oral steroids and thalidomide were the main lines of therapy in most of the reported patients. Dermatologists and pathologists should keep in mind the clinical variability of ENL to avoid misdiagnosis and delayed management. Early recognition can help control disease progression and save the patients from further complications.

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Section: Resultsmentioning

confidence: 99%

Atypical presentations of erythema nodosum leprosum: Diagnostic and therapeutic aspects

Alakad

Nofal

Assaf

2021

J Deutsche Derma Gesell

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“…Der Altersbereich war 10–73 Jahre bei einem Mittelwert ± Standardabweichung von 41,5 ± 44,5. Die dokumentierten Fälle eines atypischen ENL sind in Tabelle 1 aufgelistet [4–59].…”

Section: Ergebnisseunclassified

Atypisches Erythema nodosum leprosum: Diagnostische und therapeutische Aspekte

Alakad

Nofal

Assaf

2021

J Deutsche Derma Gesell

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ZusammenfassungDas klassische Erythema nodosum leprosum (ENL) ist klinisch durch plötzliches Auftreten druckempfindlicher erythematöser Knoten, Papeln und Plaques charakterisiert. Daneben wurden verschiedene atypische Muster, wie pustulöses, bullöses, ulzeriertes, nekrotisches und Sweet‐Syndrom‐artiges ENL beschrieben. Wir geben eine Übersicht bisher dokumentierter Fälle atypischer ENL und gehen dabei auf diagnostische und therapeutische Aspekte dieser selteneren Formen ein. Dazu wurde die medizinische Literatur in der Datenbank PubMed nach allen Fällen atypischer ENL bis zum Jahr 2020 durchsucht. Die Daten von Patienten mit atypischem ENL wurden erfasst und hinsichtlich epidemiologischer, klinisch‐histologischer und therapeutischer Aspekte analysiert. Die fünf hauptsächlich beschriebenen klinischen Formen des atypischen ENL sind vesikulär‐bullöse (46 % der Patienten), ulzerös‐nekrotische (41 %), Erythema‐multiforme‐artige (28 %), Sweet‐Syndrom‐artige (11 %) und pustulöse Läsionen (9 %). Bei allen Patienten wurden die Hautveränderungen von Fieber und Allgemeinsymptomen begleitet. Die meisten Patienten wurden oral mit Steroiden und Thalidomid therapiert. Dermatologen und Pathologen sollten die klinische Variabilität des ENL kennen, um Fehldiagnosen und verzögerte Behandlungen zu vermeiden. Die frühzeitige Erkennung kann die Kontrolle der Krankheitsprogression unterstützen und die Patienten vor weiteren Komplikationen schützen.

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“…Yuri SHIMIZU, 1 Yukinobu NAKAGAWA, 1 Yorihisa KOTOBUKI, 1 Keigo KIMURA, 2 Hideharu HAGIYA, 3 Ichiro KATAYAMA 1…”

Section: Conflict Of Interest: None Declaredmentioning

confidence: 99%

“…The stock isolated was typified as L. (V.) braziliensis, genotype Ab-2 by cyt b sequencing and two genotypes were found by low-stringency single specific primer (LSSP)-PCR technique. 3 The patient was treated with Glucantime â (Sanofi-Aventis, Sao Paulo, SP, Brazil) 10 mg/kg bodyweight per day over 28 days. After treatment, a complete cure was observed ( Fig.…”

Section: Simultaneous Occurrence Of Cutaneous and Mucocutaneous Leishmentioning

confidence: 99%

“…2 Recently, erythema nodosum leprosum (ENL) mimicking SS has been reported. 3 ENL reactions, which occur in leprosy patients with severely impaired cellular immunity, are triggered by high loads of fragmented bacilli in the skin tissues and are characterized by neutrophildominant inflammation. 4 We speculate that DDS, which has antibiotic activity against Mycobacterium leprae, might have caused the SS-like reactions by releasing fragmented bacilli in the dermis, although the effectiveness of DDS against M. haemophilum needs to be elucidated.…”

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confidence: 99%

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Case of Mycobacterium haemophilum infection presenting with Sweet's syndrome‐like reactions

Shimizu

Nakagawa

Kotobuki

et al. 2019

The Journal of Dermatology

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Erythema nodosum leprosum presenting as sweet's syndrome-like reaction in a borderline lepromatous leprosy patient

Cited by 9 publications

References 0 publications

Atypical presentations of erythema nodosum leprosum: Diagnostic and therapeutic aspects

Atypical presentations of erythema nodosum leprosum: Diagnostic and therapeutic aspects

Atypisches Erythema nodosum leprosum: Diagnostische und therapeutische Aspekte

Case of Mycobacterium haemophilum infection presenting with Sweet's syndrome‐like reactions

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