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

Morbus Hansen is an 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 sub-acute inflammation that affecting skin, nerve, mucous membrane. Type 2 reactions can be last for months and the risk of developing a dependence on steroids. Pentoxifylline (PTX) works to hampers the production of TNFα in vitro and in vivo as an alternative for ENL treatment. One case was reported in a male aged 28 years with complaints of recurring red bumps accompanied by fever and pain. On physical examination obtained erythema nodusum, with impaired sensibility in the left leg. The patient experienced improvement after being given therapy of neurodex/24 hours/oral, rifampicin 600mg, 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 400mg/8 hours/oral. In the 21 days of treatment, the redness lump improved in the middle finger and the left arm was gone. No new reddish bumps appeared and less tingling sensation.