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Minimal Erythema Dose MED Testing
Published on: May 28, 2013
Erythema Nodosum Leprosum: Update and challenges on the treatment of a neglected condition
Perpétua do Socorro Silva Costa1, Lucas Rosa Fraga2, Thayne Woycinck Kowalski3
1Postgraduate Program in Genetics and Molecular Biology. Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9500 - Prédio 43312 M, Porto Alegre, RS, Brazil; INAGEMP, Instituto Nacional de Genética Médica Populacional, R. Ramiro Barcelos, 2350 - 21506 - Santa Cecilia, Porto Alegre, RS, Brazil; Center of Social Sciences, Health and Technology. Universidade Federal do Maranhão, R. Urbano Santos, S/N, Imperatriz, MA, Brazil.
Abstract:
Erythema Nodosum Leprosum (ENL) occurs due to the immunological complication of multibacillary leprosy and is characterized by painful nodules and systemic compromising. It is usually recurrent and/or chronic and has both physical and economic impact on the patient, being a very important cause of disability. In addition, ENL is a major health problem in countries where leprosy is endemic. Therefore, adequate control of this condition is important. The management of ENL aims to control acute inflammation and neuritis and prevent the onset of new episodes. However, all currently available treatment modalities have one or two drawbacks and are not effective for all patients. Corticosteroid is the anti-inflammatory of choice in ENL but may cause dependence, especially for chronic patients. Thalidomide has a rapid action but its use is limited due the teratogenicity and neurotoxicity. Clofazimine and pentoxifylline have slow action and have important adverse effects. Finally, there is no pattern or guidelines for treating these patients, becoming more difficult to evaluate and to control this condition. This review aims to show the main drugs used in the treatment of ENL and the challenges in the management of the reaction.
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