01644nas a2200217   4500000000100000008004100001260001200042653001200054653001300066653001300079100001300092700001300105700001200118700001300130245007700143856007800220300001200298490000700310520108400317022002501401       2023                            d  bMedknow10aLeprosy10aAtypical10amimicker1 aKumari S1 aVerma GK1 aNegi AK1 aSharma A00aLepra Reactions: Mimickers and Mirror to Unmask Complex Cases of Leprosy  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152462/pdf/IDOJ-15-500.pdf  a500-5030 v153 a<p>Leprosy is a silent disease with protean manifestations, especially during lepra reactions (LRs). Cases with atypical leprosy or LR simulate a number of conditions misdiagnosed frequently. Here, three classical cases of leprosy are reported for their complex presentation. Leprosy was hidden in Case 1 due to co-existing diabetes. COVID vaccination induced LR unmasked all leprosy lesions, which were extensive, large, bizarre and spreading to various immune zones. Case 2 presented with high-grade fever, tachycardia, generalized erythema and body aches. A detailed workup unveiled his leprosy with a rare presentation of Type 1 lepra reaction (T1LR) with erythroderma and severe systemic symptoms. Case 3 mimicked sarcoidosis and lupus erythematosus (LE) on routine workup. She had facial lesions in the malar area, photosensitivity, joint pains, raised angiotensin-converting enzyme (ACE) levels and positive anti-nuclear antibodies. Peri-appendageal granulomas on histopathology and therapeutic response to multidrug therapy helped in the early diagnosis of leprosy.</p>
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