01957nas a2200385   4500000000100000008004100001260001300042653001000055653002600065653002900091653002000120653001700140653002100157653001100178653001100189653001200200653002000212653000900232653001600241653002500257653001500282653000900297653001800306653001600324100001500340700001300355700001200368700001600380245012100396300001000517490000700527050001500534520100800549022001401557       1987                            d  c1987 Sep10aAdult10aAntibodies, Bacterial10aAntigen-Antibody Complex10aChronic Disease10aCyclosporins10aErythema Nodosum10aFemale10aHumans10aleprosy10aLeukocyte Count10aMale10aMiddle Aged10aMycobacterium leprae10aPrednisone10aSkin10aT-Lymphocytes10aThalidomide1 aMiller R A1 aShen J Y1 aRea T H1 aHarnisch JP00aTreatment of chronic erythema nodosum leprosum with cyclosporine A produces clinical and immunohistologic remission.  a441-90 v55  aMILLER19873 a<p>We have treated three leprosy patients suffering from chronic, steroid-dependent erythema nodosum leprosum (ENL) with cyclosporine A (CsA). Excellent results were obtained in two patients. Extra-cutaneous manifestations of the reactional state were completely suppressed, and the development of new skin lesions was sharply curtailed. Immunohistologic abnormalities characteristic of active ENL were corrected. Lymphocyte subpopulations and anti-mycobacterial antibody levels in peripheral blood were unaffected. The third patient showed only a partial response to CsA, but satisfactory blood levels were never obtained in this individual because of dose-related gastrointestinal toxicity. The effectiveness of CsA in the treatment of ENL is consistent with the hypothesis that aberrant activation of a subset of T-helper cells is involved in the pathogenesis of this reaction. CsA may have a role in the treatment of chronic ENL that has failed to respond to conventional therapeutic modalities.</p>  a0148-916X