01053nas a2200157   4500000000100000008004100001100001200042700001400054700001400068700001400082245012100096856005100217300001500268490000700283520060500290       2019                            d1 aArora P1 aSardana K1 aAgarwal A1 aLavania M00aResistance as a cause for chronic steroid dependent ENL - a novel paradigm with potential implications in management  uhttps://leprosyreview.org/article/90/2/20-1205  a201– 2050 v903 a<p>Summary The management of Erythema Nodosum Leprosum (ENL) reactions is a challenge as the condition is chronic and recurrent, and requires treatment for a prolonged duration. The exact cause for ENL has not been ascribed, though high bacillary or antigen load perpetuates the immunological reaction. In this article, we report a case of lepromatous leprosy (LL) who presented with recurrent ENL reaction recalcitrant to therapy. Work-up showed rifampicin resistance as a potential cause for the repeated reactions and the patient responded dramatically to an alternative anti-leprosy regimen</p>