Leprosy reactions in North‐East Mexico: epidemiology and risk factors for chronic erythema nodosum leprosum

2020 ◽  
Vol 34 (5) ◽  
Author(s):  
A. Cuellar‐Barboza ◽  
J.A. Cardenas‐de la Garza ◽  
J.A. García‐Lozano ◽  
R. Vera‐Pineda ◽  
L.G. Cruz‐Gomez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Erythema Nodosum ◽  
North East ◽  
Leprosy Reactions ◽  
Erythema Nodosum Leprosum

scholarly journals Host-Related Laboratory Parameters for Leprosy Reactions

2021 ◽  
Vol 8 ◽  
Author(s):  
Yuqian Luo ◽  
Mitsuo Kiriya ◽  
Kazunari Tanigawa ◽  
Akira Kawashima ◽  
Yasuhiro Nakamura ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Clinical Symptoms ◽  
Type I ◽  
Leprosy Reactions ◽  
Erythema Nodosum Leprosum ◽  
Precise Diagnosis ◽  
Reversal Reaction

Leprosy reactions are acute inflammatory episodes that complicate the course of a Mycobacterium leprae infection and are the major cause of leprosy-associated pathology. Two types of leprosy reactions with relatively distinct pathogenesis and clinical features can occur: type 1 reaction, also known as reversal reaction, and type 2 reaction, also known as erythema nodosum leprosum. These acute nerve-destructive immune exacerbations often cause irreversible disabilities and deformities, especially when diagnosis is delayed. However, there is no diagnostic test to detect or predict leprosy reactions before the onset of clinical symptoms. Identification of biomarkers for leprosy reactions, which impede the development of symptoms or correlate with early-onset, will allow precise diagnosis and timely interventions to greatly improve the patients' quality of life. Here, we review the progress of research aimed at identifying biomarkers for leprosy reactions, including its correlation with not only immunity but also genetics, transcripts, and metabolites, providing an understanding of the immune dysfunction and inflammation that underly the pathogenesis of leprosy reactions. Nevertheless, no biomarkers that can reliably predict the subsequent occurrence of leprosy reactions from non-reactional patients and distinguish type I reaction from type II have yet been found.

scholarly journals Differential Expression of IFN-γ, IL-10, TLR1, and TLR2 and Their Potential Effects on Downgrading Leprosy Reaction and Erythema Nodosum Leprosum

2019 ◽  
Vol 2019 ◽  
pp. 1-14
Author(s):  
Douglas Eulálio Antunes ◽  
Isabela Maria Bernardes Goulart ◽  
Mayara Ingrid Sousa Lima ◽  
Patrícia Terra Alves ◽  
Paula Cristina Brígido Tavares ◽  
...  
Keyword(s):  
Path Analysis ◽  
Erythema Nodosum ◽  
Interleukin 10 ◽  
Dependence Relation ◽  
Tlr2 Expression ◽  
Leprosy Reactions ◽  
Erythema Nodosum Leprosum ◽  
Immunological Mechanisms ◽  
Ifn Γ

Leprosy reactions are acute immunological events that occur during the evolution of chronic infectious disease causing neural damage and disabilities. A study using blood samples of 17 leprosy reaction patients and 17 reaction-free was carried out by means of associations between antigens, receptors, and expression of cytokines, using path analysis providing new insights into the immunological mechanisms involved in triggering leprosy reactions. Toll-like receptors (TLR) such as TLR1 and TLR2, presented balanced expression in the reaction-free multibacillary (MB) group (TLR1: 1.01±0.23, TLR2: 1.22±0.18; p=0.267). On the other hand, downgrading type 1 reaction (T1R) (TLR1: 1.24±0.17, TLR2: 2.88±0.37; p=0.002) and erythema nodosum leprosum (ENL) (TLR1: 1.93±0.17, TLR2: 2.81±0.15; p=0.004) revealed an unbalance in relation to the expression of these receptors. When the path analysis was approached, it was noted that interleukin 10 (IL-10) expression showed a dependence relation with phenolic glycolipid I (PGL-I) in downgrading T1R (direct effect=0.503>residual effect=0.364), whereas in ENL, such relationship occurred with lipoarabinomannan (LAM) (direct effect=0.778>residual effect=0.280). On the contrary, in the reaction-free leprosy group, interferon-gamma (IFN-γ) levels were dependent on the association between TLR2 and TLR1 (0.8735). The high TLR2 expression associated with IL-10 levels, in the leprosy reaction groups, may be hypothetically related to the formation of TLR2/2 homodimers and/or TLR2/6 heterodimers linked to evasion mechanisms in downgrading reactions and pathophysiology of ENL.

scholarly journals Leprosy type 1 reactions and erythema nodosum leprosum

2008 ◽  
Vol 83 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Indira P. Kahawita ◽  
Stephen L. Walker ◽  
Diana N.J. Lockwood
Keyword(s):  
Drug Therapy ◽  
Erythema Nodosum ◽  
Significant Proportion ◽  
Nerve Damage ◽  
Successful Completion ◽  
Leprosy Reactions ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients

Leprosy reactions are a major cause of nerve damage and morbidity in a significant proportion of leprosy patients. Reactions are immunologically mediated and can occur even after successful completion of multi-drug therapy. This review focuses on the epidemiology, pathology and treatment of leprosy type 1 reactions, erythema nodosum leprosum and silent neuropathy.

Erythema nodosum leprosum, wrongly diagnosed as Sweet's disease.

1989 ◽  
Vol 51 (3) ◽  
pp. 441-446 ◽  
Author(s):  
Motoaki OZAKI ◽  
Kohozou YONEDA ◽  
Keiji OHTA ◽  
Miyuki OHTA
Keyword(s):  
Erythema Nodosum ◽  
Erythema Nodosum Leprosum

scholarly journals Radio Base Stations and Electromagnetic Fields: GIS Applications and Models for Identifying Possible Risk Factors and Areas Exposed. Some Exemplifications in Rome

2020 ◽  
Vol 10 (1) ◽  
pp. 3
Author(s):  
Cristiano Pesaresi ◽  
Davide Pavia
Keyword(s):  
Risk Factors ◽  
Electromagnetic Fields ◽  
Digital Health ◽  
Three Dimensional ◽  
Health Information System ◽  
Medical Geography ◽  
Base Stations ◽  
Buffer Zones ◽  
North East ◽  
Gis Applications

This paper—which is contextualized in the discussion on the methodological pluralism and the main topics of medical geography, the complexity theory in geographies of health, the remaking of medical geography and ad hoc systems of data elaboration—focuses on radio base stations (RBSs) as sources of electromagnetic fields, to provide GIS applications and simplifying-prudential models that are able to identify areas that could potentially be exposed to hazard. After highlighting some specific aspects regarding RBSs and their characteristics and summarizing the results of a number of studies concerning the possible effects of electromagnetic fields on health, we have taken an area of north-east Rome with a high population and building density as a case study, and we have provided some methodological and applicative exemplifications for different situations and types of antennas. Through specific functionalities and criteria, drawing inspiration from a precautionary principle, these exemplifications show some particular cases in order to support: possible risk factor identification, surveillance and spatial analysis; correlation analysis between potential risk factors and outbreak of diseases and symptoms; measurement campaigns in heavily exposed areas and buildings; education policies and prevention actions. From an operative viewpoint, we have: conducted some field surveys and recorded data and images with specific geotechnological and geomatics instruments; retraced the routes by geobrowsers and basemaps and harmonized and joined up the materials in a GIS environment; used different functions to define, on aero-satellite images, concentric circular buffer zones starting from each RBS, and geographically and geometrically delimited the connected areas subject to high and different exposure levels; produced digital applications and tested prime three-dimensional models, in addition to a video from a bird’s eye view perspective, able to show the buildings in the different buffer zones and which are subject to a hazard hierarchy due to exposure to an RBS. A similar GIS-based model—reproposable with methodological adjustments to other polluting sources—can make it possible to conceive a dynamic and multiscale digital system functional in terms of strategic planning, decision-making and public health promotion in a performant digital health information system.

Unusual non-trophic ulcerations in leprosy: A case series of 17 patients

2021 ◽  
pp. 004947552199849
Author(s):  
Prakriti Shukla ◽  
Kiran Preet Malhotra ◽  
Parul Verma ◽  
Swastika Suvirya ◽  
Abir Saraswat ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Case Series ◽  
Lepromatous Leprosy ◽  
Sweet Syndrome ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients ◽  
Atypical Presentations ◽  
Neuropathic Ulcers

Non-neuropathic ulcers in leprosy patients are infrequently seen, and atypical presentations are prone to misdiagnosis. We evaluated diagnosed cases of leprosy between January 2017 and January 2020 for the presence of cutaneous ulceration, Ridley–Jopling subtype of leprosy, reactions and histologic features of these ulcerations. Treatment was given as WHO recommended multi-bacillary multi-drug therapy. We found 17/386 leprosy patients with non-neuropathic ulcers. We describe three causes – spontaneous cutaneous ulceration in lepromatous leprosy (one nodular and one diffuse), lepra reactions (five patients with type 1; nine with type 2, further categorised into ulcerated Sweet syndrome-like who also had pseudoepitheliomatous hyperplasia, pustulo-necrotic and necrotic erythema nodosum leprosum) and Lucio phenomenon (one patient). Our series draws attention towards the different faces of non-neuropathic ulcers in leprosy, including some atypical and novel presentations.

Methotrexate in erythema nodosum leprosum: Pitfalls to avoid

2021 ◽  
pp. 004947552110561
Author(s):  
Hitaishi Mehta ◽  
Tarun Narang ◽  
Sunil Dogra ◽  
Bhushan Kumar
Keyword(s):  
Low Dose ◽  
Erythema Nodosum ◽  
Short Report ◽  
Dose Methotrexate ◽  
Atypical Features ◽  
Erythema Nodosum Leprosum

We read with interest the short report by Rani et al. entitled “An uncommon variant of erythema nodosum leprosum responding well to methotrexate: Report of two cases.” The article describes two cases of erythema nodosum leprosum (ENL) with ‘atypical features’ and good response to low dose methotrexate. The authors address a few concerns regarding methotrexate in ENL, emphasizing the rational usage of this agent.

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