02081nas a2200217   4500000000100000008004100001260003000042653003000072653002500102653002600127653002000153653001200173100001300185700002900198245011400227856006600341300001400407490000600421520142200427022001401849       2025                            d  bHanif Medisiana Publisher10aErythema Nodosum Leprosum10aExtensive ulceration10aType 2 lepra reaction10aNecrotizing ENL10aleprosy1 aAriani T1 aClarissa Maharani Putri 00aA Rare Presentation of Type 2 Lepra Reaction: Necrotizing Erythema Nodosum Leprosum with Extensive Ulceration  uhttps://www.bioscmed.com/index.php/bsm/article/view/1220/1383  a6654-66660 v93 a<p><strong>Background:</strong> Leprosy, primarily caused by Mycobacterium leprae, is a chronic infectious disease that mainly affects the skin and peripheral nerves. Type 2 leprosy reaction (ENL) is an immune complex-mediated complication characterized by inflammation of the skin, nerves, and other organs. A less common manifestation of ENL is necrotizing ENL, which presents with extensive skin necrosis and ulceration. This case report describes a rare presentation of necrotizing ENL with extensive ulceration in a young woman with borderline lepromatous leprosy.</p>

<p><strong>Case presentation:</strong> A 20-year-old female presented with multiple, progressively enlarging, painless ulcers on her right leg and painful reddish nodules on her left arm and left leg. She had a history of borderline lepromatous leprosy. Dermatological examination revealed madarosis, infiltration, nodules, hyperpigmentation macules, ulcers, and blackish crusts. Sensory testing showed hypoesthesia in the abdomen and back, and anesthesia in both lower arms and legs. Histopathological examination confirmed the diagnosis of necrotizing ENL.</p>

<p><strong>Conclusion: </strong>Necrotizing ENL is a rare and severe complication of leprosy. This case highlights the importance of early diagnosis and appropriate management with multi-drug therapy and corticosteroids to prevent significant morbidity and disability.</p>
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