01723nas a2200181   4500000000100000008004100001653002500042653002200067653001700089653002600106100001300132700001400145700001200159245011600171856026000287300001200547520098200559       2024                            d10aErythema Necroticans10asteroid dependent10aTuberculosis10aType 2 lepra reaction1 aMishra S1 aMadhual S1 aPanda M00aManaging a Case of Steroid Dependant Erythema Necroticans in a Severely Immune-compromised Patient: Case report  uhttps://scholar.google.nl/scholar_url?url=https://www.ijl.org.in/published-articles/16092024125445/6_Case_Report_Mishra_et_al_print_version.pdf&hl=nl&sa=X&d=8426358328310995088&ei=jPHwZr3mB47Zy9YP4IS1-QI&scisig=AFWwaebenc3-YSa1sDufbCvY0fwK&oi=scholaralrt&  a243-2473 a<p>Erythema necroticans is a severe manifestations of type 2 lepra reaction manifested as painful, ulcerated nodules distributed over limbs &amp; trunk, associated with systemic symptoms. Oral glucocorticoids are used as first line therapy to arrest the progression. However, due to relapsing &amp; remitting course of disease, chronic steroid use land up into many dreadful complications. Here we are reporting a case having chronic steroid dependent erythema necroticans with tuberculosis which can be a therapeutic challenge in the field of dermatology. History revealed that the patient had self-administered steroids and thalidomide for one and half year which was earlier prescribed for an episode of severe ENL and tapered off. During the course of disease, she developed tubercular arteritis leading to stroke which proved fatal. There is immense need for adequate and appropriate counselling of such patients suffering from recurrent episodes of lepra reactions.</p>