Recurrent Erythema Nodosum Leprosum Associated With Mycobacterium Indicus Pranii Vaccine In A Case Of Leprosy: A Rare paradox.

Erythema nodosum leprosum (ENL) is the commonest manifestation of type 2 lepra reaction (T2LR) due to immune complex mediated inflammation in patients of lepromatous (LL) and borderline lepromatous (BL) leprosy. Vaccines given as immunotherapy in leprosy may expedite early smear negativity and may hasten complete recovery. However, vaccination can also be associated with reactions. Majority of vaccine induced lepra reactions were reported about five decades back in the era of smallpox vaccination.