Pathogenesis of bullous erythema nodosum leprosum: a case report


  • Navdeep Kaur Department of Pathology, J. J. M. Medical College, Davangere, Karnataka



Bullous, Erythema nodosum leprosum, Leprosy


A 54 years old male, presented with acute onset of fever, malaise and body ache and multiple painful reddish swellings and fluid filled lesions in different parts of body. He gave history suggestive of several earlier episodes of type 2 lepra reactions with erythema nodosum leprosum lesions which were managed with corticosteroids. Dermatological examination revealed multiple erythematous tender nodules and plaques on face, extremities and trunk. He also had multiple bullous lesions on trunk. Investigations revealed polymorphonuclear leukocytosis and raised ESR. Biochemical investigations were normal. Slit skin smear examination showed fragmented acid fast bacilli with bacteriological index of 5+.

Author Biography

Navdeep Kaur, Department of Pathology, J. J. M. Medical College, Davangere, Karnataka

I m a pathologist , working as a senior resident


Meyerson MS. Erythema nodosum leprosum. Int J Dermatol. 1996;35:389-92 .

Pflatzgraff RE, Ramu G. Clinical leprosy. In: Hastings RC, Opromolla DVA, eds. Leprosy. 2nd ed. London: Churchill Livingstone; 1994:237-77.

Lockwood DN, Sinha HH. Pregnancy and leprosy: a comprehensive literature review. Int J Lepr Other Mycobact Dis. 1999;67:6-12.

Sethuraman G, Jeevan D, Srinivas CR, Ramu G. Bullous erythema nodosum leprosum (bullous type II reaction). Int J Dermatol. 2002;41:362-4.

Jopling WH. Reactions in leprosy (reactional states). In: Handbook of leprosy. 2nd ed. London: Heimann Medical; 1984:68-77.

Goel R, Balachandran C. Bullous necrotizing fixed drug eruption with hepatitis due to rifampicin. Indian J Lepr. 2001;73:159-61.

Dutta RK. Erythema multiforme bullosum due to dapsone. Lepr India. 1980;52:306-9.

Ramu G, Dharmendra. Acute exacerbations (reactions). Bombay: Kothari Medical Publishers;1979:116-23.

Lehman CW. Control of erythema nodosum with naproxen. Cutis. 1980;26:66-7.

Levis WR. Treatment of leprosy in United States. Bull N Acad Med. 1984;60:696-711.

Panikar V. The return of thalidomide: new uses and renewed concerns. Lepr Rev. 2003;74:286-7.




How to Cite

Kaur, N. (2020). Pathogenesis of bullous erythema nodosum leprosum: a case report. International Journal of Research in Medical Sciences, 8(12), 4509–4511.



Case Reports