01350nas a2200169   4500000000100000008004100001100001400042700001100056700001200067700001100079700001100090245005800101856005100159300001500210490000700225520094800232       2019                            d1 aPradhan S1 aRout A1 aSirka C1 aSahu K1 aDash G00aBullous erythema nodosum leprosum: a rare case series  uhttps://leprosyreview.org/article/90/4/19-0075  a469– 4750 v903 aBullous erythema nodosum leprosum (Bullous ENL) is the severe form of Type 2 lepra reaction. There are only a handful of reports of bullous ENL cases in English literature. We hereby report five cases of lepromatous leprosy with bullous erythema nodosum leprosum, of whom cases 1, 3, 4 and 5 had bullous ENL at initial
presentation, while case 2 developed bullous lesions during the fourth episode of ENL. The diagnosis was based on clinical features and histopathology. All cases had
a bacillary index more than 4þ. None of the patients had a history of previous antileprosy treatment. A history of contact with another person with leprosy was present
in two cases. All five cases were successfully treated with multidrug therapy, oral steroids and thalidomide. This case series on bullous ENL emphasises that a high
bacillary index and delay in diagnosis and treatment can lead to the more severe form of bullous Type 2 lepra reaction.