{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T16:12:27Z","timestamp":1693411947259},"reference-count":67,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T00:00:00Z","timestamp":1628812800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Das klassische Erythema nodosum leprosum (ENL) ist klinisch durch pl\u00f6tzliches Auftreten druckempfindlicher erythemat\u00f6ser Knoten, Papeln und Plaques charakterisiert. Daneben wurden verschiedene atypische Muster, wie pustul\u00f6ses, bull\u00f6ses, ulzeriertes, nekrotisches und Sweet\u2010Syndrom\u2010artiges ENL beschrieben. Wir geben eine \u00dcbersicht bisher dokumentierter F\u00e4lle atypischer ENL und gehen dabei auf diagnostische und therapeutische Aspekte dieser selteneren Formen ein. Dazu wurde die medizinische Literatur in der Datenbank PubMed nach allen F\u00e4llen atypischer ENL bis zum Jahr 2020 durchsucht. Die Daten von Patienten mit atypischem ENL wurden erfasst und hinsichtlich epidemiologischer, klinisch\u2010histologischer und therapeutischer Aspekte analysiert. Die f\u00fcnf haupts\u00e4chlich beschriebenen klinischen Formen des atypischen ENL sind vesikul\u00e4r\u2010bull\u00f6se (46\u00a0% der Patienten), ulzer\u00f6s\u2010nekrotische (41\u00a0%), Erythema\u2010multiforme\u2010artige (28\u00a0%), Sweet\u2010Syndrom\u2010artige (11\u00a0%) und pustul\u00f6se L\u00e4sionen (9\u00a0%). Bei allen Patienten wurden die Hautver\u00e4nderungen von Fieber und Allgemeinsymptomen begleitet. Die meisten Patienten wurden oral mit Steroiden und Thalidomid therapiert. Dermatologen und Pathologen sollten die klinische Variabilit\u00e4t des ENL kennen, um Fehldiagnosen und verz\u00f6gerte Behandlungen zu vermeiden. Die fr\u00fchzeitige Erkennung kann die Kontrolle der Krankheitsprogression unterst\u00fctzen und die Patienten vor weiteren Komplikationen sch\u00fctzen.<\/jats:p>","DOI":"10.1111\/ddg.14449_g","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T08:46:36Z","timestamp":1628844396000},"page":"1133-1144","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Atypisches Erythema nodosum leprosum: Diagnostische und therapeutische Aspekte"],"prefix":"10.1111","volume":"19","author":[{"given":"Rania","family":"Alakad","sequence":"first","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Zagazig University  Zagazig \u00c4gypten"},{"name":"Member of Interactive Dermatology Foundation Research group"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Nofal","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Zagazig University  Zagazig \u00c4gypten"},{"name":"Member of Interactive Dermatology Foundation Research group"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magda","family":"Assaf","sequence":"additional","affiliation":[{"name":"Pathology Department Faculty of Medicine Zagazig University  Zagazig \u00c4gypten"},{"name":"Member of Interactive Dermatology Foundation Research group"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.94278"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsi.2016.06.005"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.5455\/2349-3933.ijam20150525"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1987.tb02293.x"},{"key":"e_1_2_6_6_1","first-page":"293","article-title":"Necrotic erythema nodosum leprosum: a presenting manifestation of lepromatous leprosy","volume":"61","author":"Verma KK","year":"1993","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"e_1_2_6_7_1","first-page":"27","article-title":"Caracter\u00edsticas cl\u00ednicopatol\u00f3gicas dos estudos reacionais na Hansen\u00edase em pacientes submetidos \u00e0 poliquimioterapia (PQT)","volume":"74","author":"Nery JC","year":"1999","journal-title":"An Bras Dermatol"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2002.1428_2.x"},{"key":"e_1_2_6_9_1","first-page":"206","article-title":"Bullous reactions in leprosy: a rare phenomenon","volume":"70","author":"Dogra S","year":"2002","journal-title":"Int J Lepr"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.5070\/D321V2P87G"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.75.2.177"},{"issue":"2","key":"e_1_2_6_12_1","first-page":"122","article-title":"Erythema nodosum leprosum necroticans in a child \u2013 an unusual manifestation","volume":"73","author":"Pandhi D","year":"2005","journal-title":"Int. J. Lepr. Mycobact. Dis"},{"issue":"2","key":"e_1_2_6_13_1","first-page":"169","article-title":"Necrotic erythema nodosum leprosum","volume":"77","author":"Barman K","year":"2005","journal-title":"Indian J Lepr"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.5070\/D34MM3R7H9"},{"key":"e_1_2_6_15_1","first-page":"246","article-title":"Multiple ulcers in a young boy","volume":"16","author":"Khachemoune A","year":"2006","journal-title":"J Pak Assoc Dermatol"},{"key":"e_1_2_6_16_1","first-page":"652","article-title":"Atypical presentation of leprosy: A report of two cases","volume":"105","author":"Das S","year":"2007","journal-title":"Indian J Dermatol"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2008.02893.x"},{"issue":"2","key":"e_1_2_6_18_1","first-page":"175","article-title":"Necrotic erythema nodosum leprosum with oral mucosal involvement","volume":"80","author":"Swain JP","year":"2008","journal-title":"Indian J Lepr"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2007.02654.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.144.6.818"},{"key":"e_1_2_6_21_1","first-page":"205","article-title":"Annular vesiculobullous eruptions in type 2 reaction in borderline lepromatous leprosy","volume":"81","author":"Kar HK","year":"2009","journal-title":"Indian J Lepr"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.3329\/jom.v10i1.2002"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2009.04280.x"},{"issue":"3","key":"e_1_2_6_24_1","first-page":"221","article-title":"An unusual presentation of leprosy at diagnosis: erythema multiforme\u2010like type 2 reaction","volume":"39","author":"Sgambatti S","year":"2010","journal-title":"Revista de Patologia Tropical"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jssdds.2011.04.001"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2010.04686.x"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0074-02762012000900007"},{"key":"e_1_2_6_28_1","first-page":"17","article-title":"Type 2 Lepra reaction (ENL) presenting with extensive cutaneous ulcerations","volume":"3","author":"Yogeesh HR","year":"2012","journal-title":"Our Dermatol Online"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mjafi.2012.02.010"},{"key":"e_1_2_6_30_1","first-page":"856","article-title":"Reactional state in lepromatous leprosy simulating Sweet\u2019s syndrome","volume":"61","author":"Das T","year":"2013","journal-title":"J Assoc Physicians India"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.108101"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12324"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.85.3.201"},{"issue":"7","key":"e_1_2_6_34_1","first-page":"83","article-title":"Necrotic bullous erythema nodosum leprosum \u2013 a case report from a tertiary care centre in Eastern India","volume":"13","author":"Rit K","year":"2014","journal-title":"JDMS"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12292"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.123519"},{"key":"e_1_2_6_37_1","first-page":"325","article-title":"Erythema nodosum leprosum mimicking Sweet\u2019s syndrome","volume":"85","author":"Mahajan VK","year":"2014","journal-title":"Lepr Rev"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.86.4.387"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.86.1.96"},{"issue":"1","key":"e_1_2_6_40_1","first-page":"23","article-title":"Unusual presentation of necrotic erythema nodosum leprosum on scalp: a case report","volume":"87","author":"Barman KD","year":"2015","journal-title":"Indian J Lepr"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.5455\/ijmsph.2016.17102015251"},{"issue":"1","key":"e_1_2_6_42_1","first-page":"42","article-title":"An unusual presentation of type 2 lepra reaction: mimicking Sweet\u2019s syndrome","volume":"5","author":"Prakruthi K N","year":"2015","journal-title":"J Clin Biomed Sci"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.13221"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20164111"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12984"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.88.2.217"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.88.4.568"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.4103\/idoj.IDOJ_39_17"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.17267\/2317-3386bjmhh.v5i3.1461"},{"key":"e_1_2_6_50_1","first-page":"161","article-title":"Type 2 reaction continuing after 15 years of MDT in an atypical pattern: a case report","volume":"90","author":"Rattan R","year":"2018","journal-title":"Indian J Lepr"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.89.3.310"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmy.ijmy_186_17"},{"key":"e_1_2_6_53_1","first-page":"17","article-title":"Clinico epidemiological profile of erythema nodosum leprosum cases in Western Odisha","volume":"91","author":"Padhi T","year":"2019","journal-title":"Indian J Lepr"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmy.ijmy_49_18"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmy.ijmy_174_18"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.90.4.469"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key216"},{"key":"e_1_2_6_58_1","doi-asserted-by":"publisher","DOI":"10.5799\/jmid.614266"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.13224"},{"key":"e_1_2_6_60_1","doi-asserted-by":"crossref","first-page":"226","DOI":"10.4103\/ijmy.ijmy_26_20","article-title":"Late leprosy reaction presenting as erythema multiforme\u2010like erythema nodosum leprosum with underlying rifampicin resistance and its potential implications","volume":"9","author":"Sardana K","year":"2020","journal-title":"Int J Mycobacteriol"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.77.4.377"},{"key":"e_1_2_6_62_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002440"},{"key":"e_1_2_6_63_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.108087"},{"key":"e_1_2_6_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1996.tb03016.x"},{"issue":"8","key":"e_1_2_6_65_1","first-page":"233","article-title":"A systematic review of immunological studies of erythema nodosum leprosum","volume":"13","author":"Polycarpou A","year":"2017","journal-title":"Front Immunol"},{"key":"e_1_2_6_66_1","first-page":"658","article-title":"Gene association with leprosy: a review of published data","volume":"6","author":"Mazini PS","year":"2015","journal-title":"Front Immunol"},{"key":"e_1_2_6_67_1","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.13.140"},{"key":"e_1_2_6_68_1","first-page":"270","article-title":"Risk factors for erythema nodosum leprosum","volume":"67","author":"Manandhar R","year":"1999","journal-title":"Int J Lepr"}],"container-title":["JDDG: Journal der Deutschen Dermatologischen Gesellschaft"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ddg.14449_g","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ddg.14449_g","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ddg.14449_g","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T20:50:01Z","timestamp":1693342201000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ddg.14449_g"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":67,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/ddg.14449_g"],"URL":"https:\/\/doi.org\/10.1111\/ddg.14449_g","archive":["Portico"],"relation":{},"ISSN":["1610-0379","1610-0387"],"issn-type":[{"value":"1610-0379","type":"print"},{"value":"1610-0387","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8]]},"assertion":[{"value":"2020-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}