Familial clustering of severe atypical variants of erythema nodosum leprosum in immunocompetent siblings

The clinical picture of leprosy is very varied, with familial clustering of the disease being rare. Erythema nodosum leprosum (ENL) is a common manifestation of Type 2 reaction in leprosy. We present here two immunocompetent siblings who presented simultaneously with pustular, ulceronecrotic, bullous and impetigo like erythema nodosum leprosum.