01830nas a2200241 4500000000100000008004100001653001200042653002000054653000900074653001200083653002100095653000800116100001300124700001400137700001300151700001200164700001200176245009100188856007900279300001200358490000700370520121100377 2018 d10aleprosy10aType 2 reaction10aLate10aAnnular10aVesiculo-bullous10aMDT1 aRattan R1 aChauhan M1 aSharma A1 aTegta G1 aVerma G00aType 2 Reaction Continuing after 15 Years of MDT in an Atypical Pattern: A Case Report uhttp://www.ijl.org.in/2018/9%20R%20Rattan%20et%20al%20(CR)%20(161-166).pdf a161-1660 v903 a
Type 2 reactions may occur in the early stages of the anti-leprosy treatment, however, many cases may present 2–3 years after leprosy diagnosis. Some of such patients have been reported to develop episodes as late as 7 years after starting treatment. A 45 years old male, with a past history of intake of multi drug therapymultibacillary (MDT-MB) pack 15 years back presented with fever, generalized bodyache along with development of vesiculo-bullous lesions over the existing annular lesions of borderline lepromatous (BL) leprosy. Possibility of relapse was ruled out clinically as well as histopathologically and the patient was successfully treated with tapering doses of steroids as a case of severe type 2 reaction. Type 2 reaction is less commonly seen in BL leprosy as compared to lepromatous lepromatous (LL) leprosy. Moreover, development of vesiculo-bullous lesions in an annular pattern over existing lesions of BL leprosy as a manifestation of type 2 reaction has rarely been reported in literature. This case is even rarer as the patient is continuing to get type 2 reaction even after 15 years of completion of MDT-MB and that too in an annular pattern over the existing lesions.