A Man with Recurrent Fever and Erythema Nodosum

Abstract

Leprosy is a mycobacterial disease predominantly affecting the skin and peripheral nerves. Reactions are exacerbations manifesting in patients of leprosy throughout the spectrum. Acute forms, notably type 2 reactions, also named erythema nodosum leprosum (ENL), can also occur as the initial presentation in those without exposure to antileprosy therapy, and would be missed if leprosy is not suspected. Here we reported a peculiar case of type 2 leprosy reaction with Sweet’s syndrome-like features as the first clinical manifestation of leprosy, resulting in a delay in the diagnosis due to unusual clinical presentation. The patient had clinical and histopathological features reminiscent of Sweet’s syndrome associated with the positive result of Fite’s staining for acid fast bacilli (AFB), and review the literature of Sweet’s syndrome-like leprosy reactions briefly.