01601nas a2200181   4500000000100000008004100001653001300042653001200055653001300067100001300080700001500093700001400108700001300122245007700135856010500212300000800317520109400325       2023                            d10aAtypical10aleprosy10amimicker1 aKumari S1 aVerma G. K1 aNegi A. K1 aSharma A00aLepra Reactions: Mimickers and Mirror to Unmask Complex Cases of Leprosy  uhttps://journals.lww.com/idoj/fulltext/9900/lepra_reactions__mimickers_and_mirror_to_unmask.135.aspx  a1-43 a<p>Leprosy is a silent disease with protean manifestations, especially during lepra reactions (LRs). Cases with atypical leprosy or LR simulate a number of conditions misdiagnosed frequently. Here, three classical cases of leprosy are reported for their complex presentation. Leprosy was hidden in Case 1 due to co‑existing diabetes. COVID vaccination induced LR unmasked all leprosy lesions, which were extensive, large, bizarre and spreading to various immune zones. Case 2 presented with high‑grade fever, tachycardia, generalized erythema and body aches. A detailed workup unveiled his leprosy with a rare presentation of Type 1 lepra reaction (T1LR) with erythroderma and severe systemic symptoms. Case 3 mimicked sarcoidosis and lupus erythematosus (LE) on routine workup. She had facial lesions in the malar area, photosensitivity, joint pains, raised angiotensin‑converting enzyme (ACE) levels and positive anti‑nuclear antibodies. Peri‑appendageal granulomas on histopathology and therapeutic response to multidrug therapy helped in the early diagnosis of leprosy.</p>