Type 1 Lepra Reaction Presenting as Unilateral Perichondritis: A Case Report and Review of Literature

Isolated involvement of external ear is rare in Hansen’s disease. Ear involvement may present as infiltration, nodule formation, rat-bitten or cauliflower ear, mega lobule or as perichondritis. Herein, we present a case of a 65-year-old female who was being treated for infective perichondritis due to erythema and oedema over the right ear for two months. No other skin lesion was seen. Slit skin smear was negative. Histopathology from the lesion demonstrated a granuloma with epithelioid cells, giant cells and dense inflammatory infiltrate with no acid-fast bacilli. A diagnosis of borderline tuberculoid Hansen’s disease was made and the patient was started on systemic steroids with multidrug therapy. We also discuss previous cases with isolated involvement of one or both the ears in leprosy. We wish to highlight that high index of suspicion of leprosy is needed in cases of auricular perichondritis who do not respond to antibiotic therapy.