Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia.
Leprosy reactions are a significant cause of morbidity in leprosy population. Erythema nodosum leprosum (ENL) is an immunological complication affecting approximately 50% of patients with lepromatous leprosy (LL) and 10% of borderline lepromatous (BL) leprosy. ENL is associated with clinical feature...
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ftdoajarticles:oai:doaj.org/article:5161272294764a9c8bc20312e7bba5f8 2023-05-15T15:15:17+02:00 Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia. Edessa Negera Stephen L Walker Selfu Girma Shimelis N Doni Degafe Tsegaye Saba M Lambert Munir H Idriss Yohanis Tsegay Hazel M Dockrell Abraham Aseffa Diana N Lockwood 2017-10-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006011 https://doaj.org/article/5161272294764a9c8bc20312e7bba5f8 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5656324?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006011 https://doaj.org/article/5161272294764a9c8bc20312e7bba5f8 PLoS Neglected Tropical Diseases, Vol 11, Iss 10, p e0006011 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006011 2022-12-30T21:59:59Z Leprosy reactions are a significant cause of morbidity in leprosy population. Erythema nodosum leprosum (ENL) is an immunological complication affecting approximately 50% of patients with lepromatous leprosy (LL) and 10% of borderline lepromatous (BL) leprosy. ENL is associated with clinical features such as skin lesions, neuritis, arthritis, dactylitis, eye inflammation, osteitis, orchitis, lymphadenitis and nephritis. ENL is treated mainly with corticosteroids and corticosteroids are often required for extended periods of time which may lead to serious adverse effects. High mortality rate and increased morbidity associated with corticosteroid treatment of ENL has been reported. For improved and evidence-based treatment of ENL, documenting the systems affected by ENL is important. We report here the clinical features of ENL in a cohort of patients with acute ENL who were recruited for a clinico-pathological study before and after prednisolone treatment.A case-control study was performed at ALERT hospital, Ethiopia. Forty-six LL patients with ENL and 31 non-reactional LL matched controls were enrolled to the study and followed for 28 weeks. Clinical features were systematically documented at three visits (before, during and after predinsolone treatment of ENL cases) using a specifically designed form. Skin biopsy samples were obtained from each patient before and after treatment and used for histopathological investigations to supplement the clinical data.Pain was the most common symptom reported (98%) by patients with ENL. Eighty percent of them had reported skin pain and more than 70% had nerve and joint pain at enrolment. About 40% of the patients developed chronic ENL. Most individuals 95.7% had nodular skin lesions. Over half of patients with ENL had old nerve function impairment (NFI) while 13% had new NFI at enrolment. Facial and limb oedema were present in 60% patients. Regarding pathological findings before treatment, dermal neutrophilic infiltration was noted in 58.8% of patients with ENL compared to ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 10 e0006011 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Edessa Negera Stephen L Walker Selfu Girma Shimelis N Doni Degafe Tsegaye Saba M Lambert Munir H Idriss Yohanis Tsegay Hazel M Dockrell Abraham Aseffa Diana N Lockwood Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Leprosy reactions are a significant cause of morbidity in leprosy population. Erythema nodosum leprosum (ENL) is an immunological complication affecting approximately 50% of patients with lepromatous leprosy (LL) and 10% of borderline lepromatous (BL) leprosy. ENL is associated with clinical features such as skin lesions, neuritis, arthritis, dactylitis, eye inflammation, osteitis, orchitis, lymphadenitis and nephritis. ENL is treated mainly with corticosteroids and corticosteroids are often required for extended periods of time which may lead to serious adverse effects. High mortality rate and increased morbidity associated with corticosteroid treatment of ENL has been reported. For improved and evidence-based treatment of ENL, documenting the systems affected by ENL is important. We report here the clinical features of ENL in a cohort of patients with acute ENL who were recruited for a clinico-pathological study before and after prednisolone treatment.A case-control study was performed at ALERT hospital, Ethiopia. Forty-six LL patients with ENL and 31 non-reactional LL matched controls were enrolled to the study and followed for 28 weeks. Clinical features were systematically documented at three visits (before, during and after predinsolone treatment of ENL cases) using a specifically designed form. Skin biopsy samples were obtained from each patient before and after treatment and used for histopathological investigations to supplement the clinical data.Pain was the most common symptom reported (98%) by patients with ENL. Eighty percent of them had reported skin pain and more than 70% had nerve and joint pain at enrolment. About 40% of the patients developed chronic ENL. Most individuals 95.7% had nodular skin lesions. Over half of patients with ENL had old nerve function impairment (NFI) while 13% had new NFI at enrolment. Facial and limb oedema were present in 60% patients. Regarding pathological findings before treatment, dermal neutrophilic infiltration was noted in 58.8% of patients with ENL compared to ... |
format |
Article in Journal/Newspaper |
author |
Edessa Negera Stephen L Walker Selfu Girma Shimelis N Doni Degafe Tsegaye Saba M Lambert Munir H Idriss Yohanis Tsegay Hazel M Dockrell Abraham Aseffa Diana N Lockwood |
author_facet |
Edessa Negera Stephen L Walker Selfu Girma Shimelis N Doni Degafe Tsegaye Saba M Lambert Munir H Idriss Yohanis Tsegay Hazel M Dockrell Abraham Aseffa Diana N Lockwood |
author_sort |
Edessa Negera |
title |
Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia. |
title_short |
Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia. |
title_full |
Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia. |
title_fullStr |
Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia. |
title_full_unstemmed |
Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia. |
title_sort |
clinico-pathological features of erythema nodosum leprosum: a case-control study at alert hospital, ethiopia. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0006011 https://doaj.org/article/5161272294764a9c8bc20312e7bba5f8 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
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PLoS Neglected Tropical Diseases, Vol 11, Iss 10, p e0006011 (2017) |
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http://europepmc.org/articles/PMC5656324?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006011 https://doaj.org/article/5161272294764a9c8bc20312e7bba5f8 |
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https://doi.org/10.1371/journal.pntd.0006011 |
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PLOS Neglected Tropical Diseases |
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e0006011 |
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