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erythema nodosum leprosum

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https://www.readbyqxmd.com/read/28763338/bullous-erythema-nodosum-leprosum-as-the-first-manifestation-of-multibacillary-leprosy-a-rare-phenomenon
#1
Neha Bakshi, Seema Rao, Rohit Batra
Erythema nodosum leprosum (ENL) may uncommonly present before treatment in patients with multibacillary leprosy. Atypical manifestations are known in ENL and may be clinically misleading. Such wide variations in the clinical presentation of leprosy in reaction make histopathology an important tool for supporting clinical diagnosis. We report bullous ENL presenting as the first manifestation of leprosy in a 30-year-old Indian man diagnosed using histopathology.
July 24, 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28719256/therapeutic-dilemma-of-refractory-erythema-nodosum-leprosum
#2
Jianyu Zhu, Degang Yang, Chao Shi, Zhichun Jing
AbstractErythema nodosum leprosum (ENL), also known as type II leprosy reaction, is a severe immune-mediated complication of multibacillary leprosy. For ENL, corticosteroids and thalidomide are the mainstays of treatment. Other immunosuppressants, such as clofazimine, cyclosporine, and azathioprine have also been used. Although most patients with ENL respond well to conventional treatments, a small number are refractory to these therapies and have severe morbidity or mortality. We report the case of a 24-year-old man with refractory ENL treated with high-dose corticosteroids for 15 months...
June 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28671966/a-leprosy-clinical-severity-scale-for-erythema-nodosum-leprosum-an-international-multicentre-validation-study-of-the-enlist-enl-severity-scale
#3
MULTICENTER STUDY
Stephen L Walker, Anna M Sales, C Ruth Butlin, Mahesh Shah, Armi Maghanoy, Saba M Lambert, Joydeepa Darlong, Benjamin Jewel Rozario, Vivek V Pai, Marivic Balagon, Shimelis N Doni, Deanna A Hagge, José A C Nery, Kapil D Neupane, Suwash Baral, Biliom A Sangma, Digafe T Alembo, Abeba M Yetaye, Belaynesh A Hassan, Mohammed B Shelemo, Peter G Nicholls, Diana N J Lockwood
OBJECTIVES: We wished to validate our recently devised 16-item ENLIST ENL Severity Scale, a clinical tool for measuring the severity of the serious leprosy associated complication of erythema nodosum leprosum (ENL). We also wished to assess the responsiveness of the ENLIST ENL Severity Scale in detecting clinical change in patients with ENL. METHODS: Participants, recruited from seven centres in six leprosy endemic countries, were assessed using the ENLIST ENL Severity Scale by two researchers, one of whom categorised the severity of ENL...
July 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28656911/serum-macrophage-migration-inhibitory-factor-levels-in-leprosy-patients-with-erythema-nodosum-leprosum
#4
Frainey Bansal, Tarun Narang, Sunil Dogra, Keshavamurthy Vinay, Seema Chhabra
BACKGROUND: Erythema nodosum leprosum is an immune-mediated complication of leprosy which causes significant morbidity. Biomarkers in the pathogenesis of erythema nodosum leprosum are not yet fully determined. AIM: To determine macrophage migration inhibitory factor levels in the sera of leprosy patients with erythema nodosum leprosum and to correlate the same with clinical parameters. METHODS: This cross-sectional study included 37 consecutive leprosy patients with active erythema nodosum leprosum and 31 age- and sex-matched controls...
June 27, 2017: Indian Journal of Dermatology, Venereology and Leprology
https://www.readbyqxmd.com/read/28571559/a-mini-review-on-thalidomide-chemistry-mechanisms-of-action-therapeutic-potential-and-anti-angiogenic-properties-in-multiple-myeloma
#5
Annalisa Mercurio, Giulia Adriani, Alessia Catalano, Alessia Carocci, Luigia Rao, Giovanni Lentini, Maria Maddalena Cavalluzzi, Carlo Franchini, Angelo Vacca, Filomena Corbo
Thalidomide is a drug with interesting therapeutic properties but also with severe side effects, which require a careful and monitored use. Potential immunomodulatory, anti-inflammatory, anti-angiogenic and sedative properties make thalidomide a good candidate for the treatment of several diseases such as multiple myeloma. Through an increase in the degradation of TNFα-mRNA, thalidomide reduces the production of TNFα by monocytes and macrophages stimulated by lipopolysaccharide or by T lymphocytes induced by mitogenic stimuli...
May 31, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28521705/thalidomide-induced-deep-venous-thrombosis-in-a-case-of-steroid-dependent-erythema-nodosum-leprosum-a-management-conundrum
#6
Upinder Kaur, Sankha Shubhra Chakrabarti, Indrajeet Singh Gambhir, Rohit Singh
Thalidomide, previously banned owing to the issues of teratogenicity is being used and tested for a variety of dermatological and non dermatological conditions. The drug has been approved for the management of ENL and Multiple myeloma. The drug is commonly known to produce adverse effects like peripheral neuropathy and constipation. Deep vein thrombosis (DVT) is one of the serious adverse effects seen with thalidomide use, especially in malignancies and is relatively uncommon in non cancer settings like ENL...
May 18, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28505186/in-situ-complement-activation-and-t-cell-immunity-in-leprosy-spectrum-an-immunohistological-study-on-leprosy-lesional-skin
#7
Nawal Bahia El Idrissi, Anand M Iyer, Valeria Ramaglia, Patricia S Rosa, Cleverson T Soares, Frank Baas, Pranab K Das
Mycobacterium leprae (M. leprae) infection causes nerve damage and the condition worsens often during and long after treatment. Clearance of bacterial antigens including lipoarabinomannan (LAM) during and after treatment in leprosy patients is slow. We previously demonstrated that M. leprae LAM damages peripheral nerves by in situ generation of the membrane attack complex (MAC). Investigating the role of complement activation in skin lesions of leprosy patients might provide insight into the dynamics of in situ immune reactivity and the destructive pathology of M...
2017: PloS One
https://www.readbyqxmd.com/read/28429672/the-molecular-mechanisms-of-thalidomide-teratogenicity-and-implications-for-modern-medicine
#8
J Knobloch, D Jungck, A Koch
Thalidomide is a teratogen that affects many organs but primarily induces limb truncations like phocomelia. Rodents are thalidomide resistant. In the 1950s, this has led to misinterpretations of animal tests and to the fatal assumption that the drug was safe for pregnant women to use against morning sickness. The result was one of the biggest scandals in medical history: 10.000 and more infants with birth defects in Europe. Nonetheless, thalidomide still has its place in modern medicine as it has strong therapeutic potential: it has been approved by the FDA for multiple myeloma and erythema nodosum leprosum, and its anti-inflammatory, immunomodulatory and anti-angiogenic activities are considered in many other refractory diseases...
March 31, 2017: Current Molecular Medicine
https://www.readbyqxmd.com/read/28348555/a-systematic-review-of-immunological-studies-of-erythema-nodosum-leprosum
#9
REVIEW
Anastasia Polycarpou, Stephen L Walker, Diana N J Lockwood
Erythema nodosum leprosum (ENL) is a painful inflammatory complication of leprosy occurring in 50% of lepromatous leprosy patients and 5-10% of borderline lepromatous patients. It is a significant cause of economic hardship, morbidity and mortality in leprosy patients. Our understanding of the causes of ENL is limited. We performed a systematic review of the published literature and critically evaluated the evidence for the role of neutrophils, immune complexes (ICs), T-cells, cytokines, and other immunological factors that could contribute to the development of ENL...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28319279/borderline-lepromatous-leprosy-erythema-nodosum-leprosum-and-a-generalized-varicella-zoster-virus-infection
#10
Cornelis Kennedy, Bernard Naafs
We report the case of a thirty-year-old man with Mid-Borderline (BB) to Borderline Lepromatous Leprosy (BL) who was admitted to the hospital with blistering lesions on his upper and lower extremities. These lesions, which were partly filled with pus rapidly developed into erosions and ulcerations with hemorrhagic crusts. Other observations at time of admission included a tender erythematous plaque on his forehead, a drop foot on the right leg, muscle atrophy in both hands, a low grade fever, and pain and swelling in his right lower jaw...
March 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28222139/leprosy-reactions-the-predictive-value-of-mycobacterium-leprae-specific-serology-evaluated-in-a-brazilian-cohort-of-leprosy-patients-u-mdt-ct-br
#11
Emerith Mayra Hungria, Samira Bührer-Sékula, Regiane Morillas de Oliveira, Lúcio Cartaxo Aderaldo, Araci de Andrade Pontes, Rossilene Cruz, Heitor de Sá Gonçalves, Maria Lúcia Fernandes Penna, Gerson Oliveira Penna, Mariane Martins de Araújo Stefani
BACKGROUND: Leprosy reactions, reversal reactions/RR and erythema nodosum leprosum/ENL, can cause irreversible nerve damage, handicaps and deformities. The study of Mycobacterium leprae-specific serologic responses at diagnosis in the cohort of patients enrolled at the Clinical Trial for Uniform Multidrug Therapy Regimen for Leprosy Patients in Brazil/U-MDT/CT-BR is suitable to evaluate its prognostic value for the development of reactions. METHODOLOGY: IgM and IgG antibody responses to PGL-I, LID-1, ND-O-LID were evaluated by ELISA in 452 reaction-free leprosy patients at diagnosis, enrolled and monitored for the development of leprosy reactions during a total person-time of 780,930 person-days, i...
February 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28098596/erythema-nodosum-leprosum-like-lesions-are-a-histopathologic-pattern-in-whipple-s-disease-and-a-sign-of-the-immune-reconstitution-inflammatory-syndrome-a-case-series-and-review-of-the-literature
#12
REVIEW
Julia Liersch, Agnès Carlotti, Anne Theunis, Alexandra Leonard, Mary Barrett, John Andrew Carlson, Jörg Schaller
Inflammatory and subcutaneous nodules can arise in treated and untreated cases of Whipple disease (WD). The inflammatory immune reconstitution syndrome describes paradoxical clinical inflammatory worsening of a preexisting condition because of a return of immune function. Clinicopathologic examination of 4 patients with WD who presented with erythema nodosum leprosum (ENL)-like lesions and the findings of a systematic review of this phenomenon revealed that ENL-like lesions occurred in predominantly middle-aged male patients who suffered from WD, mostly on the legs...
April 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/27919284/can-baseline-ml-flow-test-results-predict-leprosy-reactions-an-investigation-in-a-cohort-of-patients-enrolled-in-the-uniform-multidrug-therapy-clinical-trial-for-leprosy-patients-in-brazil
#13
RANDOMIZED CONTROLLED TRIAL
Emerith Mayra Hungria, Regiane Morillas Oliveira, Gerson Oliveira Penna, Lúcio Cartaxo Aderaldo, Maria Araci de Andrade Pontes, Rossilene Cruz, Heitor de Sá Gonçalves, Maria Lúcia Fernandes Penna, Ligia Regina Franco Sansigolo Kerr, Mariane Martins de Araújo Stefani, Samira Bührer-Sékula
BACKGROUND: The predictive value of the serology to detection of IgM against the Mycobacterium leprae-derived phenolic glycolipid-I/PGL-I to identify leprosy patients who are at higher risk of developing reactions remains controversial. Whether baseline results of the ML Flow test can predict leprosy reactions was investigated among a cohort of patients enrolled in The Clinical Trial for Uniform Multidrug Therapy for Leprosy Patients in Brazil (U-MDT/CT-BR). METHODS: This was a descriptive study focusing on the main clinical manifestations of leprosy patients enrolled in the U-MDT/CT-BR from March 2007 to February 2012 at two Brazilian leprosy reference centers...
December 6, 2016: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/27859670/leprosy-reactions-in-postelimination-stage-the-bangladesh-experience
#14
M R Mowla, S Ara, A F M Mizanur Rahman, S P Tripura, S Paul
BACKGROUND: Leprosy reactions are immunologically mediated conditions and a major cause of disability before, during and after multidrug therapy (MDT). Little data have been published on the epidemiology of leprosy reactions in Bangladesh. OBJECTIVES: To describe the pattern and prevalence of leprosy reactions in the postelimination stage. METHODS: A descriptive retrospective cross-sectional study was carried out in Chittagong Medical College Hospital using the registered records of patients in the period between 2004 and 2013...
April 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/27728405/erythema-nodosum-leprosum-as-a-cause-of-pyrexia-of-unknown-origin
#15
N S Kochar, B Sehgal, B Kanish, K Kwatra, L Solomon
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27699251/cell-type-deconvolution-with-immune-pathways-identifies-gene-networks-of-host-defense-and-immunopathology-in-leprosy
#16
Megan S Inkeles, Rosane M B Teles, Delila Pouldar, Priscila R Andrade, Cressida A Madigan, David Lopez, Mike Ambrose, Mahdad Noursadeghi, Euzenir N Sarno, Thomas H Rea, Maria T Ochoa, M Luisa Iruela-Arispe, William R Swindell, Tom H M Ottenhoff, Annemieke Geluk, Barry R Bloom, Matteo Pellegrini, Robert L Modlin
Transcriptome profiles derived from the site of human disease have led to the identification of genes that contribute to pathogenesis, yet the complex mixture of cell types in these lesions has been an obstacle for defining specific mechanisms. Leprosy provides an outstanding model to study host defense and pathogenesis in a human infectious disease, given its clinical spectrum, which interrelates with the host immunologic and pathologic responses. Here, we investigated gene expression profiles derived from skin lesions for each clinical subtype of leprosy, analyzing gene coexpression modules by cell-type deconvolution...
September 22, 2016: JCI Insight
https://www.readbyqxmd.com/read/27559497/quality-of-life-in-patients-with-erythema-nodosum-leprosum-in-kuala-lumpur-malaysia
#17
Felix B Yap, Sze T Kiung, Jeffrey B Yap
BACKGROUND: There is a paucity of data on quality of life issues in patients with leprosy suffering from erythema nodosum leprosum (ENL). Thus, we aim to study the effect of ENL on quality of life. MATERIALS AND METHODS: This cross-sectional study was conducted in Hansen's Clinic, Hospital Kuala Lumpur between January 2010 and December 2013 among patients with multibacillary leprosy using the Dermatology Life Quality Index (DLQI). RESULTS: A total of 153 patients participated with 31...
July 2016: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/27556927/expression-of-cd64-on-circulating-neutrophils-favoring-systemic-inflammatory-status-in-erythema-nodosum-leprosum
#18
Veronica Schmitz, Rhana Berto da Silva Prata, Mayara Garcia de Mattos Barbosa, Mayara Abud Mendes, Sheila Santos Brandão, Thaís Porto Amadeu, Luciana Silva Rodrigues, Helen Ferreira, Fabrício da Mota Ramalho Costa, Jessica Brandão Dos Santos, Fabiana Dos Santos Pacheco, Alice de Miranda Machado, José Augusto da Costa Nery, Mariana de Andrea Hacker, Anna Maria Sales, Roberta Olmo Pinheiro, Euzenir Nunes Sarno
Erythema Nodosum Leprosum (ENL) is an immune reaction in leprosy that aggravates the patient´s clinical condition. ENL presents systemic symptoms of an acute infectious syndrome with high leukocytosis and intense malaise clinically similar to sepsis. The treatment of ENL patients requires immunosuppression and thus needs to be early and efficient to prevent both disabilities and permanent nerve damage. Some patients experience multiple episodes of ENL and prolonged use of immunosuppressive drugs may lead to serious adverse effects...
August 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27474073/dna-sensing-via-tlr-9-constitutes-a-major-innate-immunity-pathway-activated-during-erythema-nodosum-leprosum
#19
André A Dias, Camila O Silva, João Pedro S Santos, Leonardo R Batista-Silva, Chyntia Carolina D Acosta, Amanda N B Fontes, Roberta O Pinheiro, Flávio A Lara, Alice M Machado, José Augusto C Nery, Euzenir N Sarno, Geraldo M B Pereira, Maria Cristina V Pessolani
The chronic course of lepromatous leprosy may be interrupted by acute inflammatory episodes known as erythema nodosum leprosum (ENL). Despite its being a major cause of peripheral nerve damage in leprosy patients, the immunopathogenesis of ENL remains ill-defined. Recognized by distinct families of germline-encoded pattern recognition receptors, endogenous and pathogen-derived nucleic acids are highly immunostimulatory molecules that play a major role in the host defense against infections, autoimmunity, and autoinflammation...
September 1, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/27444702/immunohistochemical-assessment-of-cell-populations-in-leprosy-spectrum-lesions-and-reactional-forms
#20
Luciana Raquel Vincenzi Fachin, Cleverson Teixeira Soares, Andrea de Faria Fernandes Belone, Ana Paula Favaro Trombone, Patrícia Sammarco Rosa, Cássio Cesar Guidella, Marcello Fabiano Franco
In situ immunophenotyping of leprosy lesions can improve our understanding of the biology of inflammatory cells during the immune response to Mycobacterium leprae antigens. In the present study, biopsies from 10 healthy controls and 70 leprosy patients were selected, 10 for each of the following conditions: clinical tuberculoid (TT), borderline tuberculoid (BT), borderline borderline (BB), borderline lepromatous (BL), lepromatous (LL), reversal reaction (R1), and erythema nodosum leprosum (R2). Qualitative and quantitative immunohistochemical analyses were performed to detect CD3, CD4, CD8, FoxP3, CD20, CD138, CD1a, CD57, CD15, CD117, CD68, and CD163...
April 2017: Histology and Histopathology
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