01272nas a2200217   4500000000100000008004100001653002400042653002600066653003000092653001200122100001200134700001200146700001200158700001400170700001000184245007400194856006800268300001200336490000700348520069900355       2016                            d10alepromatous leprosy10aExacerbation reaction10aErythema Nodosum Leprosum10aleprosy1 aMisri R1 aBhole A1 aYadav S1 aKhurana V1 aKar H00aExacerbation Reaction in a Case of Lepromatous Leprosy: An Intrigue!   uhttp://www.ijl.org.in/2016/8%20R%20Misri%20et%20al(245-250).pdf  a245-2490 v883 a<p>A 24 years old male presented with multiple, shiny, infiltrated papules, plaques with central crusting and ulceration without any systemic features. Histopathological examination of the skin nodule showed perivascular and perineural collection of foamy histiocytes, few neutrophils and lymphocytes. Superficially below the epidermis there was localised area of necrosis with macrophages and infiltration of neutrophils. Fite stain was positive for AFB thus proving a diagnosis of lepromatous leprosy with exacerbation reaction. In rare instances in lepromatous leprosy exacerbation reaction occurs locally in hyperactive granulomas which may mimic erythema nodosum leprosum clinically.</p>