抄録
Since 1912, when Murata first described this syndrome called Erythema Nodosum Leprosum (ENL) as a clinical entity, we have had so many papers on ENL. The characteristics of ENL, which were clinically observed on 177 patients with lepromatous leprosy, could be arranged as follows;
1. ENL is essentially the manifestation of antigen-antibody reactions and occurs in the pure and near lepromatous patients. But some of lepromatous cases (49.4%) escape ENL in their course.
2. This condition usually starts several months to 24 months after treatment begins.
3. ENL can be graded as slight, moderate or severe in degree. This condition is definitely more frequent and more severe in clinically more advanced, more mature cases than in those with slight lesions.
4. Although ENL has become much more common since the initation of sulfone therapy, it can be caused by other antileprosy drugs including chaulmoogra oil. 5. As far as bacterial negativity is concerned, prognosis of patients with severe ENL is not always worse than that of the patients without ENL.
6. We have tried to notice previously the occurrence of ENL in the lepromatous patients. Twenty three cases of 34 new cases (68%), who took the serologic test for syphilis (STS), showed positive STS at the start of chemotherapy. These biological false positive cases of STS were confirmed by RPCF and TPHA. There was only one case who showed latent syphilis. The correlation between the occurrence of ENL and the positive STS in the lepromatous cases was statisically significant.
7. The Leproagglutination (Ogata)6), which has antigen made from cardiolipin and lecitin (1: 1) was shown in this paper as a more useful test for ENL. The lepromatous cases with positive Leproagglutination test in serum dilutions of 1: 64 or greater before chemotherapy were apt to have episodes of ENL in their clinical course (p=0.01).
