Non-pruritic eczemas as presenting manifestation of leprosy

Three patients who presented with eczemas as manifestation of leprosy are described. One of them having lepromatous leprosy had extensive areas of acquired ichthyosis. He developed asteatotic eczema on the legs. The pathophysiologic mechanisms for the development of ichthyosis and asteatotic eczema in this patient are briefly discussed. The second patient, with tuberculoid leprosy, presented with allergic contact eczema due to neomycin which he had applied over the plaque for scaling and crusting. The third patient, also with tuberculoid leprosy, presented with features of nummular eczema. Dryness of the skin that resulted from leprosy had led to the development of nummular eczema in this case. One peculiarity noted in all these eczemas was that they were non-pruritic.