De-novo Histoid Leprosy: A Series of Four Cases

Histoid leprosy, an unusual variant of lepromatous leprosy, originally thought to manifest following dapsone monotherapy, is being increasingly reported ‘de-novo’. We hereby report four de-novo cases; one mimicking lupus pernio presenting with an uncommon lesion (plaque) at an extremely rare site (nose). Of the remaining three classical cases, one exhibited a not-so-frequent development of erythema nodosum leprosum (ENL) reaction that needed modified multidrug therapy for two years, other three responded well to standard multibacillary multidrug therapy which was also given for two years.