Type 1 reaction masquerading clinically as ENL: A Case Report.

Summary: Attention is drawn to a Type 1 reaction masquerading clinically as ENL. Histology showed no evidence of ENL but suggested heightened T-cell activity (CMI), a characteristic feature of Type 1 reaction. We present a case of a 29 year old man diagnosed as lepromatous leprosy with recurrent Type 2 reaction treated with thalidomide for 2 years. The patient was referred to our institute from a teaching hospital. Skin biopsies were carried out during two separate eruptive episodes 2 months apart. Histopathology showed heightened T-cell activity, but no evidence of ENL.

Conclusion: Attention is drawn to a Type 1 reaction masquerading clinically as ENL. Histology showed no evidence of ENL but suggested heightened T-cell activity (CMI), a characteristic feature of Type 1 reaction.