Title: Erythema Necroticans- A Rare Presentation of Lepra Reaction: A Report of two Cases

Authors: Kusuma Sankula, Anila Sunandini, Smita Jonwal, Vindhya Kona, Suvarna Gorle, Sravani Alla, Siri Ambadasu

 DOI: https://dx.doi.org/10.18535/jmscr/v8i6.63

Abstract

Leprosy is chronic inflammatory disease caused by Mycobacterium leprae, affecting skin, peripheral nerves and other tissues. During long course of disease, immunological alterations occur in the form of reactions which result in sudden increase in activity of disease.

Here we present two cases, in which one case directly presented with Erythema Necroticans without preceeding symptoms of  Leprosy and the other is known  case of Borderline lepromatous leprosy with Erythema Necroticans.

Keywords: Erythema necroticans, Lepra bacilli, Fite faraco stain.

References

  1. Leprosy Reactions: Pathogenesis and Clinical Features, Hemanta Kumar Kar, Amrita Chauhan, IAL Textbook of Leprosy, Bhushan Kumar, Hemantakumar Kar, Second Edition,2016,426,427.
  2. Verma KK, Pandhi RK. Necrotic erythema nodosum leprosum; a presenting manifestation of lepromatous leprosy. Int J Lepr Other Mycobact Dis. 1993;61(2): 293‐294.
  3. Al Hayki, B. Al-Mahmoud, Erythema necroticans: A presenting manifestation of silent leprosy, Journal of Saudi society of dermatology and dermatologic surgery, 2011, 15, 63-66.
  4. Rajashekar TS, Singh G, Naik LC. Immune zones in leprosy. Indian J Dermatol. 2009;54(3):206‐210.
  5. Kumar B, Kaur I, Rai R, Mandal SK, Sharma VK. Involvement of male genitalia in leprosy [published correction appears in Lepr Rev 2001 Jun; 72 (2):244]. Lepr Rev. 2001;72(1):70‐77. doi:10.5935/0305-7518.20010011
  6. Thappa DM, Kumar RH, Karthikeyan, Ratnakar C. Scrotal lesions in lepromatous leprosy. Indian J Lepr. 1999;71(2): 223‐227.
  7. Indira D, Kaur I, Sharma VK, Das A. Palmoplantar lesions in leprosy. Indian J Lepr1999;71:167-72.
  8. Kaur I, Indira D, Dogra S,et al. “ Relatively spared zones” in leprosy: a clinicopathological study of 500 patients. Int j Lepr Other Mycobacterial Dis.2003; 71:2273.
  9. Sajad P, Hassan I, Bhat YJ, Mubashir S, Imtiyaz S, Qureshi W. Unusual presentation of borderline tuberculoid leprosy. Astrocyte 2015;2:40-1.

Corresponding Author

Dr Kusuma Sankula

Department of Dermatology, Venereology and Leprosy, Andhra Medical College, Visakhapatnam, Andhra Pradesh