The Unique Characteristic Skin Lesions of Borderline Leprosy with Severe Reversal Reaction: The Uncommon Case

Leprosy is a chronic granulomatous progresssive infectious disease caused by Mycobacterium leprae. Clinical features of leprosy is dependent upon the equilibrium between bacillary multiplication and the host cell-mediated immune response. Borderline leprosy is the immunologic intermediate of the granulomatous spectrum and is the most unstable area. The characteristic skin changes in borderline leprosy are said to be annular lesions with sharply marginated interior and exterior margins. It could be complicated by potential intermittent hypersensitivity or leprosy reactions. Reversal reaction is one of leprosy reaction that most commonly occurs in the borderline cases. We report here a case of the unique characteristic skin lesions of borderline leprosy with reversal reaction. It was the uncommon manifestation because the lesions are distributed in all over the body. Because of the reversal reaction, the lesions become more prominent and have more sharply marginated borders. This case report aims to describe the characteristic of skin lesions and clinical aspects of reversal reaction in leprosy. A 39-year-old man was diagnosed with borderline leprosy with reversal reaction who was treated by methylprednisolone for 2 weeks adding up to the multi drug therapy. There was clinical improvement and no side effect found during this study.