Abstract

A CASE REPORT ON ERYTHEMA NECROTICANS, A RARE REACTION PATTERN OF LEPROSY

Persis Joji George, Anuska Khaklari, Aesha Joshi and Mohammed Tousif Idrisi*

ABSTRACT

Erythema Nectroticans (ENe) is a rare and severe vasculonecrotic form of erythema nodosum leprosum, an immune complex-mediated reaction, that complicates the course of multibacillary leprosy. Erythema Necroticans (ENe) is an uncommon manifestation of Type 2 Erythema Nodosum Leprosum (ENL) reaction, encountered in lepromatous and borderline lepromatous cases of leprosy. A 38-year old male patient presented with skin lesions over the whole body for 10 days associated with bilateral knee joint pain. He was also presented with fever and chills for four days. The Patient developed multiple erythematous tender nodules over the bilateral upper limb, lower limb, and back. He also developed a few erosions and crusted plaques over the chest and scar tissue was present over the whole body. On sensory examination, the patient showed increased sensation of pain over nodules in lower limbs. The Patient was diagnosed with erythema necroticans and was initiated to continue his 4th MBMDT pack, an oral steroid like prednisolone and thalidomide. Thalidomide is the drug of choice in such cases. This patient showed a marked response to the given drugs such as thalidomide.

Keywords: Erythema necroticans, Erythema nodosum leprosum, MBMDT, thalidomide.