01061nas a2200157   4500000000100000008004100001100001000042700001100052700001000063700001100073245006500084300001400149490000700163520071900170022001400889       2017                            d1 aZhu J1 aYang D1 aShi C1 aJing Z00aTherapeutic Dilemma of Refractory Erythema Nodosum Leprosum.  a1362-13640 v963 a<p>AbstractErythema nodosum leprosum (ENL), also known as type II leprosy reaction, is a severe immune-mediated complication of multibacillary leprosy. For ENL, corticosteroids and thalidomide are the mainstays of treatment. Other immunosuppressants, such as clofazimine, cyclosporine, and azathioprine have also been used. Although most patients with ENL respond well to conventional treatments, a small number are refractory to these therapies and have severe morbidity or mortality. We report the case of a 24-year-old man with refractory ENL treated with high-dose corticosteroids for 15 months. The patient developed steroid-dependence and serious adverse effects, and died of an intracranial infection.</p>
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