PANKAJ DAS, SMRİTİ SHARMA, AHMED WAHEED KASHİF, BİJU VASUDEVAN, VARGHESE KOSHY, ANUJ BHATNAGAR, K LEKSHMİ PRİYA, VİNAY GERA, RAHUL THOMBRE, NİSHU BALA, ANAND MANNU, NİKUNJA KUMAR DAS
European Journal of Rheumatology - 2025;12(2):1-3
Lepra reactions are events with acute intense tissue damage in an otherwise chronic course of leprosy. Type 2 lepra reaction can present with cutaneous features, classical lesions being erythema nodosum leprosum (ENL) and its variants, and/or rheumatological features with polyarthralgia and arthritis along with systemic involvement. The ulceronecrotic variant of ENL is a marker of severe reaction and can mimic other etiologies of cutaneous vasculitides. We present a case of a young female presenting with diffuse scarring ulcers with severe constitutional symptoms, raised cytoplasmic-antineutrophil cytoplasmic antibodies (c-ANCA), mimicking necrotizing vasculitis in the absence of overt cutaneous features of leprosy, later diagnosed as ENL necroticans by a slit skin smear.
