ArticlePLoS neglected tropical diseases2017
A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale.
Article in PLoS neglected tropical diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Methotrexate and Prednisolone Study in Erythema Nodosum Leprosum (MaPS in ENL
A Pilot Study to Evaluate the Efficacy and Safety of Apremilast in Patients of Chronic and Recurrent Erythema Nodosum Leprosum
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Descriptions of the natural history of erythema nodosum leprosum to inform clinical classification - A semi-systematic review.PLoS neglected tropical diseases · 2026Pooled it
- Biologics in Leprosy: A Systematic Review and Case Report.The American journal of tropical medicine and hygiene · 2020Pooled it
- Methotrexate and Prednisolone compared to placebo and prednisolone in the treatment of severe Erythema Nodosum Leprosum: An international multicentre, double-blind randomised controlled clinical trial-MaPs in ENL.PLoS neglected tropical diseases · 2026Trial
- Longitudinal performance of the ENLIST ENL severity scale in individuals with severe erythema nodosum leprosum: Responsiveness, trajectories and clinical features - a secondary analysis of the Methotrexate and Prednisolone study - MaPs in ENL.PLoS neglected tropical diseases · 2026Trial
- Dovramilast for Erythema Nodosum Leprosum in Patients With Leprosy in Nepal: Protocol for a Phase 2 Open-Label Pilot Study.JMIR research protocols · 2026Article
- "Reactions in Leprosy: Updated Insights Into Pathophysiology, Clinical Spectrum, and Therapeutic Approaches-A Narrative Review".Health science reports · 2026Article
- Estimation of Serum Vitamin D Levels and Helminthic Coinfection in Patients with Type 2 Lepra Reactions and its Correlation with Severity of Type 2 Reactions: A Cross-Sectional Study.Indian dermatology online journal · 2025Article
- Utility of the Erythema Nodosum Leprosum International Study Severity Scale for Erythema Nodosum Leprosum: A Clinically Supported Critical Appraisal.The American journal of tropical medicine and hygiene · 2025Article
- Study of Dermal Nerve Pathology in Upgrading and Downgrading Type 1 and Type 2 Leprosy Reactions.The American journal of tropical medicine and hygiene · 2025Article
- A socio-ecological model of the management of leprosy reactions in Indonesia and India using the experiences of affected individuals, family members and healthcare providers.BMC health services research · 2025Article
- Case Report: Recurrent Type 2 Leprosy Reaction Associated with Multiple Nerve Function Impairments Refractory to Steroids: A Therapeutic Challenge.The American journal of tropical medicine and hygiene · 2024Article
- A Rare Cause of Pancytopenia From Lepromatous Leprosy Diagnosed in Bone Marrow Aspiration: A Bolt From the Blue.Cureus · 2024Article
- Localised erythema nodosum leprosum-A rare entity managed with thalidomide.Skin health and disease · 2024Article
- Neutrophilic leukocytosis and erythema nodosum leprosum in leprosy: insights from a retrospective observational study.Frontiers in immunology · 2024Observational
- Erythema nodosum after golimumab treatment in ankylosing spondylitis patients: a case report and literature review.Annals of medicine and surgery (2012) · 2023Article
- Case report: Cyclophosphamide pulse therapy for chronic recalcitrant erythema nodosum leprosum.Frontiers in medicine · 2023Article
- Metformin as adjunctive therapy in combination with multidrug treatment for multibacillary leprosy: A protocol for a randomized double-blind, controlled Phase 2 trial in Indonesia (MetLep Trial).Wellcome open research · 2023Article
- A critical appraisal of the ENLIST severity scale for erythema nodosum leprosum.PLoS neglected tropical diseases · 2022Article
- The Type I Interferon Pathway Is Upregulated in the Cutaneous Lesions and Blood of Multibacillary Leprosy Patients With Erythema Nodosum Leprosum.Frontiers in medicine · 2022Article
- Case Report: Rapid Response to Low-Dose Thalidomide in a Case of Severe Steroid Recalcitrant Erythema Nodosum Leprosum.The American journal of tropical medicine and hygiene · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 6 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe wished to validate our recently devised 16-item ENLIST ENL Severity Scale, a clinical tool for measuring the severity of the serious leprosy associated complication of erythema nodosum leprosum (ENL). We also wished to assess the responsiveness of the ENLIST ENL Severity Scale in detecting clinical change in patients with ENL.
methodsParticipants, recruited from seven centres in six leprosy endemic countries, were assessed using the ENLIST ENL Severity Scale by two researchers, one of whom categorised the severity of ENL. At a subsequent visit a further assessment using the scale was made and both participant and physician rated the change in ENL using the subjective categories of "Much better", "somewhat better", "somewhat worse" and "much worse" compared with "No change" or "about the same".
results447 participants were assessed with the ENLIST ENL Severity Scale. The Cronbach alpha of the scale and each item was calculated to determine the internal consistency of the scale. The ENLIST ENL Severity Scale had good internal consistency and this improved following removal of six items to give a Cronbach's alpha of 0.77. The cut off between mild ENL and more severe disease was 9 determined using ROC curves. The minimal important difference of the scale was determined to be 5 using both participant and physician ratings of change.
conclusionsThe 10-item ENLIST ENL Severity Scale is the first valid, reliable and responsive measure of ENL severity and improves our ability to assess and compare patients and their treatments in this severe and difficult to manage complication of leprosy. The ENLIST ENL Severity Scale will assist physicians in the monitoring and treatment of patients with ENL. The ENLIST ENL Severity Scale is easy to apply and will be useful as an outcome measure in treatment studies and enable the standardisation of other clinical and laboratory ENL research.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.