Lepromatous Leprosy and Erythema Nodosum Leprosum: Natural History

Abstract

Type II leprosy reaction is an acute state manifested by general, neural, visceral and cutaneous symptoms. Some patients present it only once; in others, there are constant reappearances. The case is presented of a 30-year-old male patient, without previous medical conditions and with family pathological antecedents of Hansen’s disease (the mother, three maternal uncles and the paternal grandmother). He remembers having received chemoprophylaxis previously. One year ago, he began with painful skin lesions, in the form of erythematous nodules on the chest, back, abdomen, and upper and lower extremities. He attends our center, where a leprosy erythema is diagnosed during lepromatous leprosy. Polychemotherapy is started and, both during treatment and at the end of it, the patient presents two other reactional states. The interesting aspect regarding this case is that erythema nodosum leprosum has manifested itself on several occasions in this patient, before treatment was started, during treatment and after it.