{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:00:23Z","timestamp":1753891223956,"version":"3.41.2"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Leprosy remains a significant public health concern in Ethiopia, with challenges in timely diagnosis and management contributing to disabilities. This case report details a 15-year-old boy who presented with diffuse nodular and bullous skin lesions, peripheral neuropathy, and systemic symptoms, ultimately diagnosed with multibacillary leprosy confirmed by a positive skin smear for acid-fast bacilli. A 15-year-old immunocompetent boy presented to the emergency department with a 2-week history of diffuse, non-pruritic skin lesions, joint swelling, numbness, and tingling sensation. The patient was febrile on arrival. Physical examination revealed an erythematous nodular skin lesion over the face and hand bilaterally and a non-blanching bullous lesion over the right leg. The left hand was swollen and tender to touch, with a superficial collection, suggestive of an abscess. There was also a hypopigmented skin lesion over the medial aspect of the left leg and thigh bilaterally with loss of sensation. There were bilateral ulnar and radial nerve enlargement, saddle nose, and tenderness at the olecranon area. The skin smear was positive for acid-fast bacilli. The patient was initially treated with corticosteroids and antibiotics, followed by referral for multidrug therapy, and was advised for further follow-up for treatment response. The case describes the critical role of early recognition and multidisciplinary management in leprosy, particularly in endemic areas. The complexity of the presentation demonstrates the need for ongoing vigilance among healthcare providers. Public health initiatives aimed at improving diagnostic capabilities and expanding leprosy services are vital for reducing the disease burden in countries such as Ethiopia.<\/jats:p>","DOI":"10.3389\/fmed.2024.1490279","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T15:57:07Z","timestamp":1737647827000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Erythema nodosum as the initial presentation of leprosy in a 15-year-old boy: a case report on Ethiopia\u2019s persistent elimination challenges"],"prefix":"10.3389","volume":"11","author":[{"given":"Kedir Negesso","family":"Tukeni","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadele Molla","family":"Aga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias Ababulgu","family":"Abadiko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Idosa Taso","family":"Mamo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamirat Godebo","family":"Woyimo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eyob Tarekegn","family":"Biru","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdo Kedir","family":"Abafogi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esayas Kebede","family":"Gudina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2555","DOI":"10.11124\/JBISRIR-2016-003301","article-title":"Effectiveness of rifampicin chemoprophylaxis in preventing leprosy in patient contacts: a systematic review of quantitative and qualitative evidence","volume":"15","author":"Ferreira","year":"2017","journal-title":"JBI Database System Rev Implement Rep"},{"key":"ref2","first-page":"389","article-title":"Global leprosy update, 2013; reducing disease burden","volume":"89","year":"2014","journal-title":"Wkly Epidemiol Rec"},{"key":"ref3","first-page":"445","article-title":"Global leprosy update, 2017: reducing the disease burden due to leprosy\u2013situation de la l\u00e8pre dans le monde, 2017: reduction de la charge de morbidit\u00e9 due \u00e0 la l\u00e8pre","volume":"93","author":"Mondiale de la Sant\u00e9","year":"2018","journal-title":"Wkly Epidemiological Rec"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1756-3305-5-240","article-title":"The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination","volume":"5","author":"Deribe","year":"2012","journal-title":"Parasit Vectors"},{"key":"ref5","first-page":"497","article-title":"Global leprosy (Hansen disease) update, 2023: elimination of leprosy disease is possible \u2013 time to act!","volume":"99","year":"2024","journal-title":"Wkly Epid Rec"},{"key":"ref6","article-title":"New development in national leprosy control programme and the issue of integration","volume":"1","author":"Tedla","year":"1984","journal-title":"Ethiop J Health Dev"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-016-1329-2","article-title":"Performance of general health workers in leprosy control activities at public health facilities in Amhara and Oromia states, Ethiopia","volume":"16","author":"Abeje","year":"2016","journal-title":"BMC Health Serv Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1186\/s12879-024-09403-z","article-title":"Tuberculosis preventive treatment uptake among people living with HIV during COVID-19 period in Addis Ababa, Ethiopia: a retrospective data review","volume":"24","author":"Gebreegziabher","year":"2024","journal-title":"BMC Infect Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1128\/CMR.19.2.338-381.2006","article-title":"The continuing challenges of leprosy","volume":"19","author":"Scollard","year":"2006","journal-title":"Clin Microbiol Rev"},{"key":"ref10","first-page":"1","article-title":"Aspectos Gerais da Hansen\u00edase, Agente Etiol\u00f3gico, Transmiss\u00e3o, Patogenia, Classifica\u00e7\u00e3o, Manifesta\u00e7\u00e3o Cl\u00ednica","author":"Talhari","year":"2015","journal-title":"Diagn\u00f3stico"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1093\/ije\/dyl072","article-title":"Socioeconomic, environmental, and behavioral risk factors for leprosy in north-East Brazil: results of a case-control study","volume":"35","author":"Kerr-Pontes","year":"2006","journal-title":"Int J Epidemiol"},{"first-page":"1","volume-title":"WHO expert committee on leprosy","year":"2012","key":"ref12"},{"key":"ref13","first-page":"77","volume-title":"Bacteriologia","author":"Aguas","year":"1999"},{"key":"ref14","first-page":"255","article-title":"Classification of leprosy according to immunity. A fivegroup system","volume":"34","author":"Ridley","year":"1966","journal-title":"Int J Lepr Other Mycobact Dis"},{"first-page":"675","volume-title":"Chemotherapy of leprosy for control programmes: report of a WHO study group","year":"1982","key":"ref15"},{"volume-title":"Technical report series, 768, sixth report","year":"1988","key":"ref16"},{"volume-title":"Enhanced global strategy for further reduce the disease burden due to leprosy (plan period 2011\u20132015) regional Office for South-East Asia","year":"2009","key":"ref17"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1309\/AJCPP72FJZZRRVMM","article-title":"A new mycobacterium species causing diffuse lepromatous leprosy","volume":"130","author":"Han","year":"2008","journal-title":"Am J Clin Pathol"},{"key":"ref19","first-page":"80","article-title":"Leprosy reactions","volume":"46","author":"Naafs","year":"1994","journal-title":"New Knowl Trop Geogr Med"},{"volume-title":"Resolutions on neglected tropical diseases: 1948\u20132013","year":"2013","key":"ref20"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1038\/1791013a0","article-title":"A new series of phenazines (rimino-compounds) with high antituberculosis activity","volume":"179","author":"Barry","year":"1957","journal-title":"Nature"},{"key":"ref22","first-page":"6","article-title":"\u201cB 663\u201d in the treatment of leprosy. Preliminary report of a pilot trial","volume":"33","author":"Browne","year":"1962","journal-title":"Lepr Rev"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"46","DOI":"10.47878\/hi.1995.v20.36487","article-title":"Intercorr\u00eancias pelas drogas utilizadas nos esquemas poliquimioter\u00e1picos em hansen\u00edase","volume":"20","author":"Gallo","year":"1995","journal-title":"Hansen Int"},{"key":"ref24","first-page":"97","article-title":"Results of a surveillance system for adverse effects in leprosy\u2019s WHO\/MDT","volume":"64","author":"Brasil","year":"1996","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"ref25","first-page":"257","article-title":"Adverse effects in Leprosy\u2019s WHO\/MDT and paramedic\u2019s role in leprosy control program regarding Brasil","volume":"65","author":"da Cunha","year":"1997","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"216","DOI":"10.47276\/lr.78.3.216","article-title":"Adverse effects from multi-drug therapy in leprosy: a Brazilian study","volume":"78","author":"Deps","year":"2007","journal-title":"Lepr Rev"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"57","DOI":"10.5935\/0305-7518.20010009","article-title":"Increase in the incidence of dapsone hypersensitivity syndrome--an appraisal","volume":"72","author":"Rao","year":"2001","journal-title":"Lepr Rev"},{"key":"ref28","first-page":"366","article-title":"Disseminated intravascular coagulopathy as an adverse reaction to intermittent rifampin schedule in the treatment of leprosy","volume":"65","author":"Souza","year":"1997","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.47878\/hi.1992.v17.35232","article-title":"As rea\u00e7\u00f5es adversas \u00e0 rifampicina com especial refer\u00eancia \u00e0 insufici\u00eancia renal aguda","volume":"17","author":"Opromolla","year":"1992","journal-title":"Hansen Int"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1490279\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T15:57:12Z","timestamp":1737647832000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1490279\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,23]]},"references-count":29,"alternative-id":["10.3389\/fmed.2024.1490279"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1490279","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2025,1,23]]},"article-number":"1490279"}}