FW: (LML) ENL and pregnancy

 

Leprosy Mailing List – December 12,  2019 

Ref.:    (LML) ENL and pregnancy

From:  Diana Lockwood, London, UK

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Dear Pieter,

Thanks for this interesting discussion.

I agree with Barbara Stryjewska that these patients are very difficult to manage.

 

Using the ENL severity scale to assess the different components of the ENL and its severity will be very helpful for managing this woman. The scale has 10 different components that are measured on a 4 point scale. It will allow assessment of response to treatment.  I attach the scale as a separate document.

1. I would manage the patients with steroids and encouragement. She will need monitoring for steroid related adverse effects.
2. The ENL will fluctuate anyway. It may decrease as her pregnancy progresses because of pregnancy related immune-suppression. 
3. Clofazimine will only have a weak effect in ameliorating the ENL.

 

Diana NJ Lockwood

Retired leprologist

London School of Hygiene & Tropical Medicine

London

UK

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder  editorlml@gmail.co

 

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