01836nas a2200217   4500000000100000008004100001653001500042653003600057653001200093653001600105653001400121100002600135700001300161700001600174700001800190700002300208700002400231245009600255520125300351022001401604       2018                            d10achallenges10aErythema nodosum leprosum (ENL)10aleprosy10aThalidomide10aTreatment1 aSocorro Silva Costa P1 aFraga LR1 aKowalski TW1 aDaxbacher ELR1 aSchüler-Faccini L1 aSales Luiz Vianna F00aErythema Nodosum Leprosum: Update and challenges on the treatment of a neglected condition.3 a<p>Erythema Nodosum Leprosum (ENL) occurs due to the immunological complication of multibacillary leprosy and is characterized by painful nodules and systemic compromising. It is usually recurrent and/or chronic and has both physical and economic impact on the patient, being a very important cause of disability. In addition, ENL is a major health problem in countries where leprosy is endemic. Therefore, adequate control of this condition is important. The management of ENL aims to control acute inflammation and neuritis and prevent the onset of new episodes. However, all currently available treatment modalities have one or two drawbacks and are not effective for all patients. Corticosteroid is the anti-inflammatory of choice in ENL but may cause dependence, especially for chronic patients. Thalidomide has a rapid action but its use is limited due the teratogenicity and neurotoxicity. Clofazimine and pentoxifylline have slow action and have important adverse effects. Finally, there is no pattern or guidelines for treating these patients, becoming more difficult to evaluate and to control this condition. This review aims to show the main drugs used in the treatment of ENL and the challenges in the management of the reaction.</p>
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