01627nas a2200229   4500000000100000008004100001260001200042653004200054653001200096653002800108100001400136700001100150700001400161700001500175700001400190245012600204856009400330300001200424490000700436520094000443022001401383       2024                            d  c01/202410aErythema nodosum leprosum necroticans10aleprosy10aType 2 leprosy reaction1 aAlfieri A1 aDewi S1 aSiswati A1 aPudjiati S1 aSoebono H00aErythema nodosum leprosum necroticans: a case report of an atypical severe type 2 leprosy reaction and literature review.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142419/pdf/1124-9390_32_2_2024_248-253.pdf  a248-2530 v323 a<p>Until now, leprosy remains a problem and challenge in the world because it can cause disability and morbidity in affected individuals, including problems due to the emergence of type 2 lepra reaction or erythema nodosum leprosum (ENL). The clinical picture of ENL can appear in an atypical and severe form, called ENL necroticans (ENN), which becomes a problem in diagnosis and therapy. We report a 17-year-old female with lepromatous leprosy and ENN who received therapy in the form of a combination of steroids and methotrexate. Four months after consuming this therapy, the ulcers on the patient's body improved, leaving atrophic and hypertrophic scars. ENN's unusual clinical presentation poses diagnostic difficulties in that its appearance does not follow the typical patterns, making it challenging to identify correctly. Furthermore, managing cases of ENN may necessitate supplementary treatment beyond steroids alone.</p>
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