Cutaneous ulceration as a presenting feature of type 1 lepra reaction: A case report. 2022

Pallavi Hegde, and Deepti Jaiswal, and Varsha M Shetty, and Kanthilatha Pai, and Raghavendra Rao
Department of Dermatology, Venereology and Leprosy, 29224Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.

Reactions in leprosy represent sudden shift in the immunological response and are seen in 11-25% of affected patients. It can be seen before, during or after the completion of multidrug therapy (MDT).1 Two types of reactions are recognized; Type 1 reaction (T1R), seen in borderline leprosy, affecting mainly skin and nerves; type 2 reaction (T2R) or erythema nodosum leprosum (ENL), seen in lepromatous leprosy, characterized by systemic features in addition to cutaneous lesions. Trophic ulcers and ulcerating ENL are well known entities while cutaneous ulceration in T1R is extremely rare; we describe an immune-competent woman with cutaneous ulceration as a presenting feature to highlight the need to recognize this entity at the earliest opportunity.

UI MeSH Term Description Entries
D007917 Leprostatic Agents Substances that suppress Mycobacterium leprae, ameliorate the clinical manifestations of leprosy, and/or reduce the incidence and severity of leprous reactions. Antileprotic Agents,Leprostatics,Agents, Antileprotic,Agents, Leprostatic
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D004893 Erythema Nodosum An erythematous eruption commonly associated with drug reactions or infection and characterized by inflammatory nodules that are usually tender, multiple, and bilateral. These nodules are located predominantly on the shins with less common occurrence on the thighs and forearms. They undergo characteristic color changes ending in temporary bruise-like areas. This condition usually subsides in 3-6 weeks without scarring or atrophy.
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012883 Skin Ulcer An ULCER of the skin and underlying tissues. Skin Ulcers,Ulcer, Skin,Ulcers, Skin
D015439 Leprosy, Borderline A form of LEPROSY in which there are clinical manifestations of both principal types (lepromatous and tuberculoid). The disease may shift toward one of these two polar or principal forms. Leprosy, Dimorphous,Borderline Leprosies,Borderline Leprosy,Dimorphous Leprosies,Dimorphous Leprosy,Leprosies, Borderline,Leprosies, Dimorphous
D015440 Leprosy, Lepromatous A chronic communicable infection which is a principal or polar form of LEPROSY. This disorder is caused by MYCOBACTERIUM LEPRAE and produces diffuse granulomatous skin lesions in the form of nodules, macules, or papules. The peripheral nerves are involved symmetrically and neural sequelae occur in the advanced stage. Leprosy, Cutaneous,Leprosy, Nodular,Cutaneous Leprosies,Cutaneous Leprosy,Lepromatous Leprosies,Lepromatous Leprosy,Leprosies, Cutaneous,Leprosies, Lepromatous,Leprosies, Nodular,Nodular Leprosies,Nodular Leprosy

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