01315nas a2200229   4500000000100000008004100001260001200042653001300054653001900067653001200086653002000098653001500118100001200133700001400145700001300159700001000172700001000182245009000192300002000282520076900302022001401071       2022                            d  c01/202210aLazarine10aLepra reaction10aleprosy10aType 1 reaction10aUlceration1 aHegde P1 aJaiswal D1 aShetty V1 aPai K1 aRao R00aCutaneous ulceration as a presenting feature of type 1 lepra reaction: A case report.  a4947552110686613 a<p>Reactions in leprosy represent sudden shift in the immunological response and are seen in 11-25% of affected patients. It can be seen before, during or after the completion of multidrug therapy (MDT). Two types of reactions are recognized; Type 1 reaction (T1R), seen in borderline leprosy, affecting mainly skin and nerves; type 2 reaction (T2R) or erythema nodosum leprosum (ENL), seen in lepromatous leprosy, characterized by systemic features in addition to cutaneous lesions. Trophic ulcers and ulcerating ENL are well known entities while cutaneous ulceration in T1R is extremely rare; we describe an immune-competent woman with cutaneous ulceration as a presenting feature to highlight the need to recognize this entity at the earliest opportunity.</p>
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