01791nas a2200325   4500000000100000008004100001260001600042653001200058653003600070653002100106653002200127653001600149653002100165100001800186700001400204700001800218700001200236700001500248700001000263700001600273700001200289700001800301700001200319245011700331856015300448300000600601490000700607520083700614022001401451       2025                            d  bElsevier BV10aLeprosy10aErythema nodosum leprosum (ENL)10aNecrotic lesions10aMultidrug therapy10aThalidomide10aImmunomodulation1 aNagarajan HDP1 aKamaraj B1 aSelvanathan K1 aKumar S1 aGaidhane S1 aSah S1 aSatapathy P1 aMehta R1 aNdabashinze R1 aVerma A00aNecrotic erythema nodosum leprosum – A case of severe lepromatous reaction in a multibacillary leprosy patient  uhttps://www.sciencedirect.com/science/article/pii/S2214250925000071/pdfft?md5=7ce518cf2b9020c4914e1e8435b90a5f&pid=1-s2.0-S2214250925000071-main.pdf  a40 v393 a<p>Necrotic erythema nodosum leprosum (ENL) is an uncommon and severe complication of multibacillary leprosy, characterized by intense systemic inflammation, ulcerative lesions, and significant morbidity. This case report describes a 32-year-old male presenting with recurrent type 2 lepra reactions and necrotic lesions exacerbated by inconsistent adherence to multidrug therapy (MDT). The patient’s management involved MDT, corticosteroids, thalidomide, and hydroxychloroquine, which led to a substantial clinical improvement. Emerging evidence and a multidisciplinary approach have been used to address this complex pathophysiology and clinical presentation. This report demonstrates the necessity for uninterrupted treatment, early recognition, and tailored therapeutic interventions for managing severe lepra reactions.</p>
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