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Apremilast in chronic recalcitrant erythema nodosum leprosum: A report of two cases.

Abstract

Erythema nodosum leprosum (ENL) is a severe immune reaction commonly encountered as a complication in patients with multibacillary leprosy. Management of chronic ENL in leprosy is challenging and necessitates use of systemic immunosuppressants, including corticosteroids and thalidomide. No single drug is universally effective and most current therapeutic agents carry significant risk of systemic toxicity. Apremilast is an orally effective phosphodiesterase-4 (PDE-4) inhibitor with a potent immunomodulatory action and is clinically effective in inflammatory conditions like chronic plaque psoriasis. We report two patients of chronic ENL who were poorly controlled despite use of multiple therapeutic agents. Both patients demonstrated significant clinical improvement with apremilast, without any adverse effects, thereby suggesting its potential as a novel therapeutic option in chronic ENL. This article is protected by copyright. All rights reserved.

More information

Type
Journal Article
Author
Narang T
Kaushik A
Dogra S