01248nas a2200205   4500000000100000008004100001260001200042653001900054653002100073653003000094100001300124700001100137700001200148700001000160700002200170700001400192245007700206520074500283022001401028       2024                            d  c12/202410aSweet Syndrome10aDermatopathology10aErythema Nodosum Leprosum1 aSidhom S1 aYang E1 aGowda A1 aKim L1 aRobinson-Bostom L1 aMassoud C00aAtypical Type 2 Lepra Reaction Masquerading as Recurrent Sweet Syndrome.3 a<p>Erythema nodosum leprosum (ENL) is an immune complex-mediated response in Mycobacterium leprae infection, presenting with fever, arthralgias, and tender cutaneous lesions. It mimics Sweet syndrome (SS) clinically and histologically but requires distinct management. A 65-year-old man with recent travel presented with fever and edematous plaques. Initial findings supported SS, improving with corticosteroids. Symptom recurrence and a contact's leprosy diagnosis led to further testing, revealing M. leprae through repeat staining and tissue PCR. This case underscores the need to consider ENL in Sweet-like cases with relevant travel history. Repeat staining and molecular testing are essential for accurate diagnosis and treatment.</p>  a1600-0560