02420nas a2200277   4500000000100000008004100001260004400042653002100086653003100107653005200138653002900190653002600219653004200245653002400287100001500311700001200326700001400338700001200352700001000364700001500374245011100389856008800500300000800588520153200596022001402128       2024                            d  bSpringer Science and Business Media LLC10aGeneral Medicine10apostoperative complication10aDrug-Related Side Effects and Adverse Reactions10aMulti drug therapy (MDT)10aType 2 lepra reaction10aimmune-mediated inflammatory diseases10aHansens’s disease1 aHembrom SB1 aAhmed G1 aKarim HMR1 aSingh V1 aRai P1 aMeshram SV00aSteroid Premedication Might Protect From Postoperative Erythema Nodosum Leprosum in Leprosy: A Case Report  uhttps://assets.cureus.com/uploads/case_report/pdf/236193/20240312-32716-1bm2a3p.pdf  a1-53 a<p>Leprosy is known for its diverse pathophysiologic involvement and resulting multisystemic manifestation and morbidities. Despite global efforts to eliminate this public health illness, it is still prevalent in some Asian and European countries. Perioperative management of a leprosy patient is challenging owing to the indirect and direct involvement of the airway, respiratory, and cardiac systems; treatment-related side-effects involving the hepato-renal systems affecting the anesthesia techniques and drugs pharmacokinetic and pharmacodynamics. While anaesthesiologists are aware of such happenings and often tailor the anesthesia management for the concerning issues, immunological aspects of the disease and drug-related adverse events are less enquired about, such as type-2 lepra reaction, i.e., erythema nodosum leprosum (ENL), etc. Further, data on perioperative ENL management and prevention are still being determined. We report one case of a 52-year-old female who underwent gynecology surgery and developed ENL on the third postoperative day, which was managed using Steroids. Unfortunately, the patient had a surgical site infection, which required another surgery within the month, while the patient was still under the steroid successfully without any adverse events. Although a single case cannot provide causation or association, the case is presented to highlight the probable preventive action of steroids on the occurrence of postoperative ENL, where surgical stress is considered a risk factor.</p>
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