Reactive perforating leprosy: pustular erythema nodosum leprosum with epidermal perforation and liberation of Mycobacterium leprae

摘要

A 4 5-year-old Indian man presented with a 10-day history of asymptomatic skin lesions all over the trunk and limbs following fever, body ache, and bilateral testicular pain. He had consulted a private practitioner in his village, who had diagnosed the lesions as furuncles and prescribed some tablets and capsules (nature unknown) and topical gentian violet lotion. This treatment had provided little relief after one week of therapy. The patient had a known diagnosis of lepromatous leprosy and had been treated with World Health Organization (WHO) multibacillary multi-drug therapy (MB MDT) using tablet dapsone, rifampicin, and clofazimine for the previous three months by a leprosy eradication unit near his village.