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Necrotizing Vasculitis Due to a Severe Type II Leprosy Reaction

Abstract

Introduction: Despite the wide spectrum of the clinical manifestations of leprosy, necrotizing cutaneous vasculitis has rarely been reported as a manifestation of this disease. We report a case of cutaneous vasculitis due to a type II leprosy reaction, secondary to lepromatous leprosy. Case report: A 38-years-old Gambian man was admitted for necrotic and infiltrated purpura of acral distribution (limbs, ears and nose), which was associated with multiple subcutaneous inflammatory nodules, epistaxis, polyarthralgia, fever and a poor general health status. Mycobacterium Leprae was isolated from the nasal mucosa (bacillary index 3 +) and the biopsy of the purpuric lesions revealed a leukocytoclastic vasculitis. A multidrug therapy concurrently with oral corticosteroids was started with good clinical results after 4 weeks. Discussion: Cutaneous necrotizing vasculitis has been described as a rare manifestation of eryhtema nodosum leprosum in medical literature. We think, in endemic areas, erythema nodosum leprosum can be added to the list of the possible etiologies of cutaneous vasculitis.

More information

Type
Journal Article
Author
Diallo M
Diack N D
Diatta B A
Ndiaye A
Dieng M T