Dermoscopy of Type 1 Lepra Reaction in Skin of Color

Leprosy reactions are immunological reactions due to the changes in a patient’s immune status in response to Mycobacterium leprae that may occur before, during, or even after the completion of multidrug therapy. Leprosy reactions are divided into 2 types. Type 1 lepra reaction (reversal reaction) is characterized by the development of acute erythema and swelling of existing skin lesions or by the appearance of new lesions and/or neuritis. Type 2 lepra reaction (erythema nodosum leprosum) is the appearance of skin nodules due to the immune complex–mediated complication of leprosy. T1R is a type IV hypersensitivity reaction that occurs mostly in borderline leprosy patients. Clinically, T1R may present with similar morphology to other granulomatous skin conditions such as lupus vulgaris (LV), sarcoidosis, and granuloma faciale. As we know, dermoscopy can be used to facilitate the differential diagnosis of granulomatous skin conditions. The present study aims to describe dermoscopic patterns in T1R according to the severity of lesions and the type of leprosy.