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Related Experiment Videos

Type II lepra reaction: an unusual presentation.

S Chauhan1, S D'Cruz, H Mohan

  • 1Department of Medicine, Government Medical College and Hospital, Sector 32, Chandigarh, India. drsc88@rediffmail.com

Dermatology Online Journal
|April 28, 2006
PubMed
Summary

Leprosy can present unusually with ulcerative skin lesions and maculo-papular rash, often mistaken for other conditions. This case highlights type-2 lepra reaction presenting with ulcers, fever, and systemic symptoms.

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Pathology

Background:

  • Leprosy, a chronic infectious disease, typically presents with skin lesions and nerve damage.
  • Ulcers and maculo-papular rash are uncommon manifestations of leprosy.
  • Type-2 lepra reaction (erythema nodosum leprosum) can rarely present as ulcerative lesions.

Observation:

  • A young male presented with multiple ulcers and maculo-papular rash on the legs, chest, and abdomen.
  • The patient exhibited systemic symptoms including fever, heart murmur, pulmonary infiltrates, neuropathy, and abnormal liver function.
  • Initial differential diagnoses included infective endocarditis and systemic necrotizing vasculitis.

Findings:

  • Skin biopsy revealed dense inflammation and the presence of lepra bacilli.

Related Experiment Videos

  • Histopathological findings were consistent with a type-2 lepra reaction.

    • Implications:

    • This case underscores the importance of considering leprosy in the differential diagnosis of unusual ulcerative skin conditions.
    • Recognizing atypical presentations of type-2 lepra reaction is crucial for timely diagnosis and treatment.
    • Highlights the diagnostic challenge posed by leprosy's diverse clinical spectrum.