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Volume 355:739 August 17, 2006 Number 7
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Treatment of Recurrent Erythema Nodosum Leprosum with Infliximab

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To the Editor: A 52-year-old woman with multibacillary (borderline lepromatous) leprosy, who had been treated intermittently with dapsone since 1965, presented to our department in 1996 with active skin lesions, a positive bacterial index (5+) on skin biopsy, and an elevated level of antibodies against Mycobacterium leprae specific to phenolic glycolipid I. She was treated with multidrug therapy (rifampin, dapsone, and clofazimine). One and a half years after treatment was started, disseminated painful erythematous nodules and plaques, or erythema nodosum leprosum, developed owing to an augmented immunologic response to mycobacterial antigens. These symptoms did not respond adequately to repeated courses . . . [Full Text of this Article]




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