Chronic erythema nodosum leprosum in Hansen's disease: a challenging clinical management.

IF 1.6 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-08-22 DOI:10.1093/trstmh/trag091

Michele Spinicci, Anna Barbiero, Tommaso Manciulli, Costanza Fiorelli, Roberto Fedi, Alessandro Bussotti, Elena Silvestri, Danilo Malandrino, Giacomo Emmi, Giovanni Gazzoli, Lorenzo Zammarchi, Alessandro Bartoloni

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Abstract

Introduction: Chronic erythema nodosum leprosum (ENL) is a challenging complication of Hansen's disease (HD), with limited treatment options and frequent steroid dependence. Anti-tumour necrosis factor (TNF)-α agents are promising alternatives, though evidence remains confined to a few reports.

Case description: We report the case of a 34-year-old Moroccan man with multibacillary Hansen's disease, who developed chronic ENL with recurrent systemic and cutaneous flares, requiring prolonged immunomodulatory therapy. Corticosteroids, thalidomide, azathioprine, methotrexate, and anti-TNF-α therapy only provided incomplete control. After six years of recurrences requiring several hospitalizations, treatment with methylprednisolone, high-dose thalidomide, and clofazimine achieved a sustained remission, allowing gradual treatment discontinuation.

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麻风病慢性麻风结节性红斑：一个具有挑战性的临床管理。

慢性麻风结节性红斑（ENL）是汉森病（HD）的一种具有挑战性的并发症，治疗选择有限，并且经常依赖类固醇。抗肿瘤坏死因子(TNF)-α药物是有希望的替代品，尽管证据仍然局限于少数报道。病例描述：我们报告一例34岁摩洛哥男子多菌汉森病，谁发展慢性ENL与复发性全身和皮肤的火焰，需要长期的免疫调节治疗。皮质类固醇、沙利度胺、硫唑嘌呤、甲氨蝶呤和抗tnf -α治疗仅提供不完全控制。复发6年后，多次住院治疗，甲强的松龙、大剂量沙利度胺和氯法齐明治疗获得持续缓解，允许逐渐停止治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transactions of The Royal Society of Tropical Medicine and Hygiene 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.00

自引率

9.10%

发文量

115

审稿时长

4-8 weeks

期刊介绍： Transactions of the Royal Society of Tropical Medicine and Hygiene publishes authoritative and impactful original, peer-reviewed articles and reviews on all aspects of tropical medicine.