02033nas a2200265   4500000000100000008004100001260001000042653002400052653002000076653003100096653001200127100001400139700001300153700001100166700001300177700001800190700001200208700001300220245007200233856005200305300000800357490000700365520138100372022001401753       2024                            d  bLepra10aLepromatous Leprosy10aLepra reactions10atuberculosis lymphadenitis10aleprosy1 aAgrawal T1 aGupta SK1 aRana S1 aKhalid A1 aShrivastava V1 aGupta B1 aGautam P00aChronic recurrent erythema nodosum due to lepromatous lymphadenitis  uhttps://leprosyreview.org/article/95/2/20-23033  a1-50 v953 a<p>Leprosy is mostly confined to the skin and peripheral nervous system, although other organs including lymph nodes may sometimes be involved. A 30-year-old male presented to the OPD with fever and reddish raised lesions over the leg for 3–4 months and left inguinal region swelling for 18 months. He had developed a cough and weight loss, and after attending various hospitals had been diagnosed with tuberculosis. On examination, there were erythematous nodules and post-inflammatory hyperpigmentation mainly over the extremities and a few over the back. Sensory and motor examination were normal. On nerve examination, the left common peroneal nerve was slightly thickened. A biopsy showed non-specific inflammation. A slit-skin smear was negative for acid-fast bacilli. Fine needle aspiration cytology (FNAC) from submental, right and left inguinal swellings proved it to be a case of lepromatous lymphadenitis. The patient was started on thalidomide, methotrexate and multidrug therapy (MDT) to which he responded.</p>

<p>The case illustrates that lymphadenopathy in a young patient with no initial cutaneous symptoms, deformities, or sensory or motor dysfunction, does not obviously suggest leprosy, but the differential diagnosis should be kept in mind, especially in endemic areas, even in cases where the initial presentation is primarily lymphadenopathy.</p>
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