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Erythema nodosum leprosum and orbital involvement
Upreet Dhaliwal1, Sandeep Mohanty, Sambit N Bhattacharya
1Department of Ophthalmology, University College of Medical Sciences, GTB Hospital, Delhi. upreetdhaliwal@hotmail.com
Summary
This study details the first case of erythema nodosum leprosum (ENL) affecting the orbit in a lepromatous leprosy patient with recurrent ENL on multidrug therapy (MDT). Despite treatment, severe eye injury occurred, highlighting treatment challenges.
Area of Science:
- Ophthalmology
- Dermatology
- Infectious Diseases
Background:
- Leprosy is a chronic infectious disease caused by Mycobacterium leprae.
- Erythema nodosum leprosum (ENL) is a common inflammatory complication of leprosy.
- Multidrug therapy (MDT) is the standard treatment for leprosy.
Observation:
- This report describes a unique case of ENL involving the orbit.
- The patient had lepromatous leprosy and experienced recurrent ENL episodes.
- The patient was undergoing MDT for leprosy.
Findings:
- This is the first documented instance of ENL affecting the orbital region.
- Severe ocular injury developed despite ongoing ENL management and appropriate treatment.
- The case highlights the potential for severe complications even with standard care.
Implications:
- Orbital involvement in ENL can lead to significant visual impairment.
- Current treatment protocols may be insufficient for managing severe ocular manifestations of ENL.
- Further research is needed to understand and improve the management of ENL-related orbital complications.