Type II lepra reaction: an unusual presentation.
Ulcers with maculo-papular rash are an unusual presenting feature of leprosy. They occur as result of neuropathy, type-2 lepra reaction or Lucio's phenomenon. The hall mark of type-2 reaction is erythema nodosum. Very rarely it manifests as ulcerative skin lesions. We describe one such unusual case of a young male who presented with multiple ulcers and maculo-papular rash over the legs, chest and abdomen. In addition to this, he had fever, heart murmur, pulmonary infiltrates, neuropathy, and deranged liver function. A clinical differential diagnosis of infective endocarditis and systemic nectrozing vasculitis was made. Skin biopsy showed dense inflammation with lepra bacilli consistent with type-2 lepra reaction.
Chauhan
S
S
Department of Medicine, Government Medical College and Hospital, Sector 32, Chandigarh, India. drsc88@rediffmail.com
D'Cruz
S
S
Mohan
H
H
Singh
R
R
Ram
J
J
Sachdev
A
A
D000005:Abdomen; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007866:Leg; D007917:Leprostatic Agents / Q000627:therapeutic use; D015440:Leprosy, Lepromatous / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000382:microbiology; D008297:Male; D012871:Skin Diseases / Q000382:microbiology* / Q000473:pathology*; D013909:Thorax; D014057:Tomography, X-Ray Computed; D014456:Ulcer / Q000382:microbiology* / Q000473:pathology*
D000900:Anti-Bacterial Agents; D007917:Leprostatic Agents