Clinical Case Vignettes

Erythema nodosum leprosum

Pooja Dhaon


Author Affiliations

Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India


*Correspondence: Dr. Pooja Dhaon


IJRCI. 2016;4(1):V1

Received: 12 October 2015, Accepted: 27 October 2015, Published: 23 January 2016




Erythema nodosum leprosum (ENL) is a type 2 reaction, which is a humoral response to Mycobacterium Leprae infection. The fig. 1 and 2 depict the presentation of a 30-year-old with arthritis of large joints and dactylitis. Since 2 years, he had progressive nodular ulcerative lesions over trunks, thighs and upper-extremities (Fig. 3, 4, 5 and 6), and madarosis and nodular lesions on both the ear lobes (Fig. 7 and 8). Further evaluation of skin biopsy and histopathological examination confirmed the diagnosis of lepromatous leprosy with type 2 reaction.


Fig. 1 and 2: Presentation of dactylitis in toes

Fig. 3, 4, 5 and 6: Nodular ulcerative lesions with central crusting, Fig. 5 shows inverted saucer-shaped leprosy lesion



Fig. 7 and 8: Madarosis and nodular lesions on both the ear lobes



Competing interests

The author declares that they she has no competing interests.