De-novo Ulceration - Rare Lazarine Leprosy - like Presentation of Borderline Lepromatous Hansen's Disease

ABSTRACT

Leprosy is caused by Mycobacterium leprae, which has a distinct predilection for cooler parts of the body. There are many forms of leprosy that range from the mildest indeterminate form to the most severe lepromatous type. The type of disease an individual develops depends on the host immune status; with tuberculoid type being seen in those with good immunity and lepromatous form in individuals with poor immunity to leprosy bacillus. Deep ulcers may occur in association with erythema nodosum leprosum, Lazarine leprosy and Lucio phenomenon. We report a male who presented with multiple acute onset foul smelling stellate ulcers over bilateral extremities. He was diagnosed as Borderline lepromatous leprosy (not in reaction) on the basis of histopathology. This type of presentation has not been reported till date.