• Tarun Narang, Sunil Dogra, and Inderjeet Kaur.
• Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
• J Cutan Med Surg. 2008 May 1; 12 (3): 139-41.

BackgroundLepromatous leprosy (LL) is a generalized disease, usually with numerous papules, nodules, or plaques containing abundant Mycobacterium leprae and affecting wide areas of the skin.AimTo report on an LL patient presenting with two lesions on the face and to discuss its epidemiologic significance in the current context of leprosy elimination.MethodsA 52-year-old housewife presented to our department with erythematous lesions over her face for 2 months. Her husband and son were treated for multibacillary leprosy 15 years previously. An infiltrated erythematous nodule was located over the right supraorbital area, and a single papule was present on the right eyelid. The rest of the examination was normal.ResultsA slit skin smear from the lesion revealed a bacillary index of 6+ and a morphologic index of 6%. A skin biopsy showed atrophic epidermis with an underlying clear grenz zone; the dermis showed massive infiltration of foamy macrophages, filled with bacilli and a few lymphocytes.ConclusionsThe presentation of LL or borderline lepromatous leprosy (BL) as a single cutaneous lesion (or localized lesions) is a rare presentation of multibacillary disease, and such cases can be undertreated. This case also highlights the need to further explore the role of immunoprophylaxis or chemoprophylaxis in the contacts of multibacillary cases.

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