Pentoxifylline therapy for patients with type 2 leprosy reactions: erythema nodosum leprosum in steroid-dependent cases

Abstract

Introduction. Morbus Hansen is the infectious disease which causes by bacilli intracellular Mycobacterium leprae which mainly affects the skin and peripheral nerves. The leprosy reaction is an episode an immunologically mediated episode of acute or subacute inflammation which affecting skin; nerve; mucous membrane. Type 2 reactions can be last for months and risk of developing dependence on steroids. Pentoxifylline (PTX) works to hampers the production TNF in vitro and in vivo; are an alternative for ENL treatment. Case Report. One case was reported in a male aged 28 years with complaints of recurring red bumps accompanied by fever and pain. Discussion. On physical examination obtained erythema nodosum; with impaired sensibility in the left leg. The patient experienced improvement after being given therapy of neurodex/24 hours/oral; rifampicin 600 mg; ofloxacin 400 mg; minocycline 100 mg which given 3x for a week; and combination therapy to treat the Leprosy reaction given the combination of methylprednisolone 16mg (3-2-0) and Pentoxifylline 400 mg/8 hours/oral. Conclusion. In the 21 day of treatment; the redness lump improved in the middle finger and left arm was gone. No new reddish bumps appeared and less tingling sensation.

Keywords

• morbus hansen
• erythema nodosum leprosum
• pentoxifylline
• steroid dependence
• leprosy reaction