01986nas a2200265   4500000000100000008004100001260001200042653002900054653001900083653002500102653001200127653001600139653001500155100001600170700001000186700001300196700001400209700001800223245009400241856004300335300000700378490000700385520131400392022001401706       2025                            d  bMDPI AG10aMycobacterium Infections10aNontuberculous10aMycobacterium leprae10aLeprosy10aLepromatous10aArmadillos1 aChiriboga G1 aGuo Q1 aZuberi E1 aPowers HR1 aRueda Prada L00aErythema Nodosum Leprosum in a Patient with Borderline Lepromatous Leprosy: A Case Report  uhttps://www.mdpi.com/2036-7449/17/4/83  a830 v173 a<p><strong>Background:</strong> Leprosy, caused by Mycobacterium leprae, presents on a spectrum ranging from tuberculoid to lepromatous disease. Borderline lepromatous leprosy represents an unstable immunological state that predisposes patients to immune-mediated reactions, including erythema nodosum leprosum (ENL), a severe inflammatory complication.</p>

<p><strong>Case Presentation:</strong> We report a case of a 62-year-old female with borderline lepromatous leprosy who presented with recurrent facial cellulitis and later developed disseminated ENL. She was initially diagnosed following a series of facial infections and confirmatory skin biopsy. Months later, she developed systemic inflammatory lesions consistent with ENL, requiring hospitalization. She was treated with high-dose corticosteroids for ENL and methotrexate to treat type 1 reaction and continued multidrug therapy (MDT) with minocycline, rifampin, and clarithromycin for leprosy, which led to significant clinical improvement.</p>

<p><strong>Conclusion:</strong> This case highlights the diagnostic challenges of leprosy in the United States and the importance of recognizing ENL as a severe immunologic complication requiring prompt intervention. A multidisciplinary approach is essential for optimal patient outcomes.</p>
  a2036-7449