01750nas a2200421   4500000000100000008004100001260001600042653001200058653001000070653002600080653002800106653003000134653002100164653002800185653001100213653000800224653002300232653002500255653001800280653000900298653001800307653001100325653003100336653001000367100001400377700001300391700001200404700001200416700001000428700001400438245005300452856004500505300000700550490000700557050001600564520073400580022001401314       2006                            d  c2006 Jan 2710aAbdomen10aAdult10aAnti-Bacterial Agents10aDiagnosis, Differential10aDrug Therapy, Combination10aEchocardiography10aEndocarditis, Bacterial10aHumans10aLeg10aLeprostatic Agents10aLeprosy, lepromatous10aLung Diseases10aMale10aSkin Diseases10aThorax10aTomography, X-Ray Computed10aUlcer1 aChauhan S1 aD'Cruz S1 aMohan H1 aSingh R1 aRam J1 aSachdev A00aType II lepra reaction: an unusual presentation.  uhttp://escholarship.org/uc/item/448655c6  a180 v12  aCHAUHAN20063 a<p>Ulcers with maculo-papular rash are an unusual presenting feature of leprosy. They occur as result of neuropathy, type-2 lepra reaction or Lucio's phenomenon. The hall mark of type-2 reaction is erythema nodosum. Very rarely it manifests as ulcerative skin lesions. We describe one such unusual case of a young male who presented with multiple ulcers and maculo-papular rash over the legs, chest and abdomen. In addition to this, he had fever, heart murmur, pulmonary infiltrates, neuropathy, and deranged liver function. A clinical differential diagnosis of infective endocarditis and systemic nectrozing vasculitis was made. Skin biopsy showed dense inflammation with lepra bacilli consistent with type-2 lepra reaction.</p>  a1087-2108