A case of lepromatous leprosy with co-existing tuberculosis verrucosa cutis (TVC)

The association of leprosy and cutaneous tuberculosis has been reported rarely. Though cross-immunity may exist between these two mycobacterial infections, tuberculosis can occur throughout the spectrum of leprosy. We report a case of lepromatous leprosy with Type II reaction, with tuberculosis verrucosa cutis (TVC). The patient presented with multiple skin-coloured tender nodules of variable size, involving the upper and lower extremities, nodular enlargement of both ear lobes, erythematous plaques on the face and icthyotic patches over both lower legs and feet, for 6 months. There was also a slow-growing asymptomatic warty plaque over the right lateral malleolus, present for 1 year. Slit skin smear examination from ear lobes, forehead and nodules, and histopathology of the warty lesion, respectively confirmed the diagnoses of leprosy and tuberculosis.