A curious case of Lepromatous Leprosy Developing Complete loss of Pigmentation, followed by Reappearance of Pigmentation with Multi Drug Therapy (MDT) alone - A Support for Neural Theory of Vitiligo Pathogenesis?

Lepromatous leprosy is a multisystem disease characterized by a decline in delayed hypersensitivity to Mycobacterium leprae antigens, causing multiplication of bacilli in huge numbers. We herein report a case of an adult male with lepromatous leprosy who was started on adult multibacillary multi-drug therapy. With treatment, the surface of lesions developed depigmented macules and patches. However, on continuation of antileprotic drugs, there was progressive perifollicular as well as inter-follicular re-pigmentation. This case clinically depicts re-pigmentation of depigmented skin following multidrug therapy for leprosy supporting the role of neural system in the homeostasis of melanocytes.