Borderline lepromatous leprosy: Cutaneous manifestation and type 1 reversal reaction

Abstract

Leprosy is a chronic granulomatous infection of the skin and peripheral nerves by an acid-fast bacillus, Mycobacterium leprae. Leprosy reactions involve spontaneous fluctuations in the clinical features, and T-cell reactivity to mycobacterial antigens. Type 1 reversal reactions (T1R) occur in cases of borderline leprosy, and 30% of patients with borderline leprosy are at risk of experiencing T1R (1). T1R can occur at any time, but frequently appears after starting multiple drug therapy (MDT). We report here a case of borderline lepromatous leprosy with T1R. It was difficult to confirm the diagnosis in this case because T1R without neurological symptoms overlapped with the cutaneous manifestation of borderline leprosy before MDT.