01544nas a2200301 4500000000100000008004100001260001600042653001000058653002100068653001500089653001100104653001100115653002100126653002400147653002500171653003700196653002200233653003200255100001300287700001100300700001600311245012200327856006600449300001100515490000700526520069500533022001401228 2011 d c2011 Mar 0110aAdult10aErythema Nodosum10aEtanercept10aFemale10aHumans10aImmunoglobulin G10aImmunologic Factors10aLeprosy, lepromatous10aReceptors, Tumor Necrosis Factor10aTreatment Outcome10aTumor Necrosis Factor-alpha1 aRamien M1 aWong A1 aKeystone JS00aSevere refractory erythema nodosum leprosum successfully treated with the tumor necrosis factor inhibitor etanercept. uhttp://cid.oxfordjournals.org/content/52/5/e133.full.pdf+html ae133-50 v523 a
Erythema nodosum leprosum (ENL), or type II reaction, is a common complication of lepromatous leprosy that can cause significant patient debility. First-line therapy includes prednisone and thalidomide, with clofazimine reserved for patients who do not respond to first-line treatment. We present the case of a 33-year-old woman with ENL that failed to respond adequately to conventional therapy over a 6-year period. Because of the severe nature of her disease and the adverse effects of therapy that she experienced, a trial of etanercept was undertaken, which led to full resolution of her ENL. The rationale behind our choice of therapy and its future implications are discussed.
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