01651nas a2200205 4500000000100000008004100001653002200042653002300064653001200087653001000099653003600109100001700145700001100162245010800173856007700281300001100358490000600369050001700375520105300392 2013 d10aSystematic review10aMulti drug therapy10aleprosy10aIndia10aErythema nodosum leprosum (ENL)1 aVoorend CG N1 aPost E00aA systematic review on the epidemiological data of erythema nodosum leprosum, a type 2 leprosy reaction uhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789767/pdf/pntd.0002440.pdf ae2440.0 v7 aVOOREND 20133 a
This systematic review addresses an underpublicized and yet highly significant leprosy topic. Erythema Nodosum Leprosum (ENL) is a serious complication in multi-bacillary (MB) leprosy that may lead to severe disability. Inflammatory skin nodules may result in nerve and organ damage and require high doses of immunosuppressive drugs. ENL can occur long after patients are released from antibiotic treatment. Frequency and severity of ENL is unknown; this review confirms the lack of accurate data at global, regional, and national levels. Available data indicates that ENL incidence ranges between 0.7–4.6% of all MB cases and late reoccurrence up to 8 years after release from treatment. ENL episodes often reoccur, with an average of 2.6 times. The main risk factor for ENL is a high bacteriological index. Additionally, data indicate a wide variation of ENL occurrence between and within countries. The conclusions demonstrate the need for increased awareness about ENL, in research, patient surveillance, and in programme management.