The Risk Factor Analysis of Erythema Nodosum Leprosum in a Tertiary Hospital in Surabaya, Indonesia

A three-year retrospective study of multibacillary leprosy patients suffering from erythema nodosum leprosum (ENL) in a tertiary hospital in Surabaya city, East Java, Indonesia, with a minimum of 2 to 5 years follow up period, was conducted to analyse the risk factors associated with ENL. Multivariate analyses result showed leprosy type lepromatous leprosy (odds ratio [OR]=78.664; 95% confidence interval [CI] = 13.635-453.827; p<0.0001) and borderline lepromatous leprosy (OR= 24.756; 95% CI= 5.052-121.320; p<0.0001), as well as coinfection (OR = 42.963; 95% CI = 3.778-488.585; p=0.002) are significant risk factors of ENL. While gender, age, bacterial index (BI), morphological index (MI), nutritional status were not significantly associated with ENL. The ENL patients were predominantly male, 20-40 years old, suffered from lepromatous leprosy (LL) type leprosy, with BI 3+ and positive MI, and have normal weight. Finding risk factors that may be associated with ENL will help increase physician's alertness to provide better health care. A comprehensive examination and early recognition of possible risk factors will enhance health care quality in monitoring, educating, as well as providing prompt and appropriate treatment in order to help reduce ENL morbidity.