An unusual presentation of lepromatous leprosy as inguinal lymphadenopathy

Background: Leprosy is a chronic granulomatous inflammatory lesion caused by Mycobacterium Leprae with usual manifestations on skin, peripheral nerves, upper respiratory tract and testis with rare lesions in lymphnodes.

Involvement of lymphnode without cutaneous and nerve lesions is very rare.

Methods: Herewith, we are reporting a case of lepromatous leprosy, involving the inguinal lymphnodes with no cutaneous or nerve lesions.

Results:

The inguinal node was sent for histopathological examination which confirmed lepromatous leprosy. On further examination, patient had no cutaneous or nerve lesions. As the patient had fever, he was put on ofloxacin and he developed painful nodules in the legs and arms - clinically appearing like Type 2 lepra reaction. This skin lesion was biopsied and microscopic appearance with special stains confirmed lepromatous leprosy.

Conclusion:

This highlights the unusual presentation of leprosy and hence leprosy should be considered by the clinicians and pathologists as one of the differential diagnosis of lymphnode enlargement.