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A male 26 years old patient with BB type of leprosy was encountered with a typical clinical presentations of up-grading (reversal) Type 1 Lepra Reaction. These included sudden appearance of tender, erythematous nodular eruptions mimicking ENL, severe constitutional symptoms like high grade fever, malaise, vomiting, epistaxis, joint pain and tenosynovitis simulating Type 2 Lepra Reaction. To the best of our knowledge, this may be the first such case in our hand.
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