Chronic erythema nodosum leprosum in Hansen’s disease: a challenging clinical management
Abstract
Introduction. Chronic erythema nodosum leprosum (ENL) is a challenging complication of Hansen’s disease (HD), with limited treatment options and frequent steroid dependence. Anti-tumour necrosis factor (TNF)-α agents are promising alternatives, though evidence remains confined to a few reports.
Case description. We report the case of a 34-year-old Moroccan man with multibacillary Hansen’s disease, who developed chronic ENL with recurrent systemic and cutaneous flares, requiring prolonged immunomodulatory therapy. Corticosteroids, thalidomide, azathioprine, methotrexate, and anti-TNF-α therapy only provided incomplete control. After six years of recurrences requiring several hospitalizations, treatment with methylprednisolone, high-dose thalidomide, and clofazimine achieved a sustained remission, allowing gradual treatment discontinuation.
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BibTeX
@article{spinicci2026chronic,
title = {{Chronic erythema nodosum leprosum in Hansen’s disease: a challenging clinical management}},
author = {Michele Spinicci and Anna Barbiero and Tommaso Manciulli and Costanza Fiorelli and Roberto Fedi and Alessandro Bussotti and Elena Silvestri and Danilo Malandrino and Giacomo Emmi and Giovanni Gazzoli and Lorenzo Zammarchi and Alessandro Bartoloni},
journal = {Transactions of the Royal Society of Tropical Medicine and Hygiene},
year = {2026},
month = aug,
doi = {10.1093/trstmh/trag091},
url = {https://doi.org/10.1093/trstmh/trag091},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Chronic erythema nodosum leprosum in Hansen’s disease: a challenging clinical management
AU - Michele Spinicci
AU - Anna Barbiero
AU - Tommaso Manciulli
AU - Costanza Fiorelli
AU - Roberto Fedi
AU - Alessandro Bussotti
AU - Elena Silvestri
AU - Danilo Malandrino
AU - Giacomo Emmi
AU - Giovanni Gazzoli
AU - Lorenzo Zammarchi
AU - Alessandro Bartoloni
PY - 2026
DA - 2026/08/22
JO - Transactions of the Royal Society of Tropical Medicine and Hygiene
DO - 10.1093/trstmh/trag091
UR - https://doi.org/10.1093/trstmh/trag091
AB - Introduction. Chronic erythema nodosum leprosum (ENL) is a challenging complication of Hansen’s disease (HD), with limited treatment options and frequent steroid dependence. Anti-tumour necrosis factor (TNF)-α agents are promising alternatives, though evidence remains confined to a few reports. Case description. We report the case of a 34-year-old Moroccan man with multibacillary Hansen’s disease, who developed chronic ENL with recurrent systemic and cutaneous flares, requiring prolonged immunomodulatory therapy. Corticosteroids, thalidomide, azathioprine, methotrexate, and anti-TNF-α therapy only provided incomplete control. After six years of recurrences requiring several hospitalizations, treatment with methylprednisolone, high-dose thalidomide, and clofazimine achieved a sustained remission, allowing gradual treatment discontinuation.
SN - 0035-9203
SN - 1878-3503
ER -