{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:04:02Z","timestamp":1790708642021,"version":"4.1.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,2,21]],"date-time":"2020-02-21T00:00:00Z","timestamp":1582243200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hansen\u2019s disease (HD) is rare in the United States, but a steady number of cases are diagnosed annually, especially in southern areas where armadillos are present. Challenges associated with erythema nodosum leprosum (ENL), a complication of multibacillary leprosy, call for novel regimens. We present a case of a man with recalcitrant ENL from HD likely acquired in the United States. He required a combination of 4 drugs to control chronic ENL.<\/jats:p>","DOI":"10.1093\/ofid\/ofaa060","type":"journal-article","created":{"date-parts":[[2020,2,21]],"date-time":"2020-02-21T07:09:37Z","timestamp":1582268977000},"source":"Crossref","is-referenced-by-count":4,"title":["A Challenging Case of Domestically Acquired Leprosy in the Southern United States"],"prefix":"10.1093","volume":"7","author":[{"given":"Shruthi","family":"Mohan","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica K","family":"Fairley","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,21]]},"reference":[{"key":"2020031207572738800_CIT0001","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1128\/CMR.00079-13","article-title":"Leprosy in the 21st century","volume":"28","author":"White","year":"2015","journal-title":"Clin Microbiol Rev"},{"key":"2020031207572738800_CIT0002","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/S1473-3099(11)70006-8","article-title":"Leprosy now: epidemiology, progress, challenges, and research gaps","volume":"11","author":"Rodrigues","year":"2011","journal-title":"Lancet Infect Dis"},{"key":"2020031207572738800_CIT0003","author":"NHDP","year":"2019"},{"key":"2020031207572738800_CIT0004","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jdcr.2016.03.004","article-title":"Increasing incidence of leprosy and transmission from armadillos in Central Florida: a case series","volume":"2","author":"Domozych","year":"2016","journal-title":"JAAD Case Rep"},{"key":"2020031207572738800_CIT0005","doi-asserted-by":"crossref","first-page":"101","DOI":"10.47276\/lr.87.1.101","article-title":"Autochthonous borderline tuberculoid leprosy in a man from Florida","volume":"87","author":"Villada","year":"2016","journal-title":"Lepr Rev"},{"key":"2020031207572738800_CIT0006","article-title":"Cutaneous leprosy in Central Florida man with significant armadillo exposure","volume":"12:e229287","author":"Logas","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2020031207572738800_CIT0007","doi-asserted-by":"crossref","first-page":"e00557","DOI":"10.1016\/j.idcr.2019.e00557","article-title":"Major risk factors for leprosy in a non-endemic area of the United States: a case series","volume":"17","author":"Aslam","year":"2019","journal-title":"IDCases"},{"key":"2020031207572738800_CIT0008","first-page":"188","article-title":"Indigenous cases of leprosy (Hansen\u2019s disease) in Southern Mississippi","volume":"56","author":"Marcos","year":"2015","journal-title":"J Miss State Med Assoc"},{"key":"2020031207572738800_CIT0009","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.3201\/eid2112.150501","article-title":"Zoonotic leprosy in the Southeastern United States","volume":"21","author":"Sharma","year":"2015","journal-title":"Emerg Infect Dis"},{"key":"2020031207572738800_CIT0010","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.jaad.2014.03.034","article-title":"Recognizing and managing the immunologic reactions in leprosy","volume":"71","author":"Kamath","year":"2014","journal-title":"J Am Acad Dermatol"},{"key":"2020031207572738800_CIT0011","first-page":"255","article-title":"Classification of leprosy according to immunity. 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