Type II lepra reaction: an unusual presentation

Dermatol Online J. 2006 Jan 27;12(1):18.


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.

Publication types

  • Case Reports

MeSH terms

  • Abdomen
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Echocardiography
  • Endocarditis, Bacterial / diagnostic imaging
  • Endocarditis, Bacterial / drug therapy
  • Endocarditis, Bacterial / microbiology
  • Humans
  • Leg
  • Leprostatic Agents / therapeutic use
  • Leprosy, Lepromatous / complications*
  • Leprosy, Lepromatous / drug therapy
  • Leprosy, Lepromatous / pathology*
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / microbiology
  • Male
  • Skin Diseases / microbiology*
  • Skin Diseases / pathology*
  • Thorax
  • Tomography, X-Ray Computed
  • Ulcer / microbiology*
  • Ulcer / pathology*


  • Anti-Bacterial Agents
  • Leprostatic Agents