A 22-year-old woman with borderline lepromatous leprosy develops recurrent episodes of fever with tender erythematous nodules despite prednisolone. She wishes to conceive soon. Which drug is most effective for ENL but must be avoided in her because of teratogenicity?

• A Thalidomide ✓
• B Clofazimine 300 mg daily
• C Methotrexate
• D Colchicine

Explanation

Thalidomide is the most rapidly effective agent for erythema nodosum leprosum, acting through TNF-alpha suppression, but it is strictly contraindicated in women who may become pregnant because of phocomelia and other severe birth defects. Steroids remain the preferred option in women of reproductive age, with high-dose clofazimine as an alternative steroid-sparing agent. Methotrexate and colchicine have no established role in ENL.

Reference: Rook's Textbook of Dermatology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.