{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:16:33Z","timestamp":1785935793453,"version":"3.56.0"},"reference-count":24,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T00:00:00Z","timestamp":1646179200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Erythema nodosum leprosum (ENL) is an acute immune complex-mediated condition of the dermis, subcutaneous tissue, and other tissues seen in patients with multibacillary (MB) leprosy, causing severe impairment to patients\u2019 quality of life. To date, there is no standard diagnostic criteria for ENL. We aimed to study the diagnostic value and accuracy of Neutrophil-to-Lymphocyte ratio (NLR), Lymphocyte-to-Monocyte ratio (LMR), and Platelet-to-Lymphocyte ratio (PLR) in diagnosing ENL. This is an analytic retrospective study with a cross-sectional design that describes the distribution and clinical characteristics of all newly diagnosed MB patients of Dr. Soetomo General Hospital Surabaya in the years 2018\u20132020. NLR, LMR, and PLR were calculated for all patients, and a receiver operating characteristic curve (ROC) was generated to identify the cut-off points. Among a total of 182 patients with MB leprosy, 22 cases (12.09%) were reported with ENL. WBC, neutrophils, monocytes, and thrombocytes showed a positive correlation with the incidence of ENL, but not lymphocytes. The NLR cut-off point for the diagnosis of ENL was 4.99 (sensitivity 86.4%, specificity 82.5%, accuracy 82.97), while that of PLR was 237.46 (sensitivity 63.6%, specificity 73.1%, accuracy 71.98%). LMR had poor sensitivity and specificity levels of 50% and 28.7%, with cut-off point of 2.28 and accuracy of 31.32%. These results suggest that NLR and PLR could be potential biomarkers for the diagnosis of ENL.<\/jats:p>","DOI":"10.3390\/tropicalmed7030039","type":"journal-article","created":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T22:53:56Z","timestamp":1646261636000},"page":"39","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1420-0348","authenticated-orcid":false,"given":"Natalia","family":"Tanojo","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga\/Dr. Soetomo General Academic Hospital, Jl. Mayjen Prof. Dr. Moestopo No. 6\u20138, Surabaya 60286, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Damayanti","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga\/Dr. Soetomo General Academic Hospital, Jl. Mayjen Prof. Dr. Moestopo No. 6\u20138, Surabaya 60286, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Budi","family":"Utomo","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No. 47, Surabaya 60132, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evy","family":"Ervianti","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga\/Dr. Soetomo General Academic Hospital, Jl. Mayjen Prof. Dr. Moestopo No. 6\u20138, Surabaya 60286, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5486-5291","authenticated-orcid":false,"given":"Dwi","family":"Murtiastutik","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga\/Dr. Soetomo General Academic Hospital, Jl. Mayjen Prof. Dr. Moestopo No. 6\u20138, Surabaya 60286, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cita","family":"Prakoeswa","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga\/Dr. Soetomo General Academic Hospital, Jl. Mayjen Prof. Dr. Moestopo No. 6\u20138, Surabaya 60286, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Listiawan","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga\/Dr. Soetomo General Academic Hospital, Jl. Mayjen Prof. Dr. Moestopo No. 6\u20138, Surabaya 60286, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,2]]},"reference":[{"key":"ref_1","unstructured":"WHO (2020). Global leprosy (Hansen disease) update, 2019: Time to step-up prevention initiatives. Wkly. Epidermiol. Rec., 95, 417\u2013440."},{"key":"ref_2","unstructured":"World Health Organization (2021). Towards Zero Leprosy. 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