01849nas a2200229   4500000000100000008004100001260001600042653002300058653002000081653003000101653002100131100001200152700001200164700001200176700001600188245005600204856015300260300000800413490000700421520117700428022001401605       2024                            d  bElsevier BV10aHansen’s disease10aLepra reactions10aErythema Nodosum Leprosum10aPerforating type1 aSarda B1 aMadke B1 aSaoji V1 aKondalkar A00aPerforating ENL: A variant of type 2 lepra reaction  uhttps://www.sciencedirect.com/science/article/pii/S2405579424000949/pdfft?md5=ff3644ee541a562bdd73bf9d074df497&pid=1-s2.0-S2405579424000949-main.pdf  a1-40 v383 a<p>Lepra reactions are acute episodic inflammatory reactions that occur during illness due to abrupt changes in the body’s immunological response against Mycobacterium leprae. These are of two types, type 1 and type 2. Type 2 reaction is also called Erythema Nodosum Leprosum (ENL).</p>

<p>The common skin lesion in ENL is a red, tender, raised lesion. Subcutaneous nodules can also appear. The skin lesions may present as vesicles, pustules, or bulla. They can also develop ulcers and become necrotic. Some patients may experience skin lesions that resemble those seen in erythema multiforme. A rare desquamative rash may occur, which needs to be differentiated from a drug-related rash. Healing lesions may leave scars that may become inflamed during ENL flare-ups. In rare instances, there may be no skin lesions suggesting ENL.</p>

<p>Reactive perforating type of erythema nodosum leprosum (ENL) is a rare type 2 lepra reaction occurrence, observed in lepromatous leprosy and borderline lepromatous cases. It is linked with the involvement of several organs, so if diagnosis and treatment are delayed, it can result in complications and a grim prognosis.</p>
  a2405-5794