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Necrotic erythema nodosum leprosum.

K Deb Barman1, U Gupta, K Saify

  • 1Department of Dermatology and Venereology, NSCB Medical College, Jabalpur 482003, Madhya Pradesh. kdebbarman@yahoo.com

Indian Journal of Leprosy
|July 28, 2005
PubMed
Summary

A 30-year-old farmer developed fever, joint pain, and multiple ulcers. Biopsy revealed erythema nodosum leprosum, a leprosy complication, treated with corticosteroids.

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Pathology

Background:

  • Erythema nodosum leprosum (ENL) is a common inflammatory complication of leprosy.
  • It presents with various mucocutaneous manifestations, often requiring prompt diagnosis and management.

Observation:

  • A 30-year-old farmer presented with a 15-day history of fever, arthralgia, and multiple ulcerations.
  • Ulcers were noted on the perianal area, forearms, wrists, buttocks, thighs, and shins, characterized by necrotic bases and raised margins.
  • Associated findings included black atrophic scars and hyperpigmented macules on the lower extremities.

Findings:

  • Excision biopsy of an ulcer demonstrated histopathological features consistent with erythema nodosum leprosum.
  • The clinical presentation and biopsy results confirmed ENL as the cause of the patient's symptoms.

Implications:

  • This case highlights the diverse mucocutaneous presentations of ENL, even in non-endemic regions.
  • Early recognition and appropriate treatment, such as systemic corticosteroids, are crucial for managing ENL and preventing further complications.

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