01891nas a2200301   4500000000100000008004100001260001700042653001000059653002100069653001100090653001100101653002300112653001200135653000900147653001600156653001300172653000900185653001700194100001500211700001500226700001700241700001300258245005200271300001100323490000600334520123500340022001401575       1986                            d  c1986 Apr-Jun10aAdult10aErythema Nodosum10aFemale10aHumans10aLeprostatic Agents10aleprosy10aMale10aMiddle Aged10aNecrosis10aSkin10aTime Factors1 aHusser J A1 aDaumerie D1 aGrossetete G1 aNebout M00a[Necrotic course of erythema nodosum leprosum].  a239-500 v43 a<p>During 2 years, 25 lepromatous patients were hospitalised in the Hansen complications room of Institut Marchoux. Between these patients, 9 developed a Necrotic Erythema Nodosum Leprosum. A review of the observed clinic effects is established and 3 types of signs are isolated and discussed: necrotic extension after big nodes on chest and arms, a punch crater complicating small nodes, and a sclerous xylodermia on arms and legs. The course of this complication is estimated about six months average, with pauses and relapses with general and subjectives symptoms. The final course shows side effects: anemia, denutrition, functional disabilities of joint movements and cutaneous straps. In the group of 9 patients, 3 died. We did not find relations between the necrotic phenomenon and therapy or occurred diseases. The best drug to stop the necrotic processus is thalidomide 400 mg daily and decrease 100 mg when the signs fall near normality. One or two mg/kg each day coricosteroides were tested: the effect is unconstant, the duration of action is shorter. Side effects occur rapidly and patient will become corticosteroïd dependent. The importance of bath with disinfectants is high. We did not observed surinfection.</p>  a0001-5938