Sarda Bhakti, Madke Bhushan, Saoji Vikrant, Kondalkar Ambika
Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.
J Clin Tuberc Other Mycobact Dis. 2024 Dec 16;38:100507. doi: 10.1016/j.jctube.2024.100507. eCollection 2025 Feb.
Lepra reactions are acute episodic inflammatory reactions that occur during illness due to abrupt changes in the body's immunological response against Mycobacterium leprae. These are of two types, type 1 and type 2. Type 2 reaction is also called Erythema Nodosum Leprosum (ENL). The common skin lesion in ENL is a red, tender, raised lesion. Subcutaneous nodules can also appear. The skin lesions may present as vesicles, pustules, or bulla. They can also develop ulcers and become necrotic. Some patients may experience skin lesions that resemble those seen in erythema multiforme. A rare desquamative rash may occur, which needs to be differentiated from a drug-related rash. Healing lesions may leave scars that may become inflamed during ENL flare-ups. In rare instances, there may be no skin lesions suggesting ENL. Reactive perforating type of erythema nodosum leprosum (ENL) is a rare type 2 lepra reaction occurrence, observed in lepromatous leprosy and borderline lepromatous cases. It is linked with the involvement of several organs, so if diagnosis and treatment are delayed, it can result in complications and a grim prognosis.
麻风反应是在麻风病病程中，由于机体对麻风杆菌的免疫反应突然改变而发生的急性发作性炎症反应。分为1型和2型两种。2型反应也称为结节性红斑型麻风（ENL）。ENL常见的皮肤损害是红色、压痛、隆起的损害。也可出现皮下结节。皮肤损害可表现为水疱、脓疱或大疱。还可发展为溃疡并坏死。一些患者可能出现类似多形红斑的皮肤损害。可能会出现罕见的剥脱性皮疹，需要与药物相关皮疹相鉴别。愈合的损害可能会留下瘢痕，在ENL发作时可能会发炎。在极少数情况下，可能没有提示ENL的皮肤损害。反应性穿通性结节性红斑型麻风（ENL）是一种罕见的2型麻风反应，见于瘤型麻风和界线类偏瘤型病例。它与多个器官受累有关，因此如果诊断和治疗延迟，可导致并发症和预后不良。
