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Erythema nodosum leprosum (type 2 reaction) in a patient with neurofibromatosis type 1
  1. Rohith George,
  2. Sydney D'Souza and
  3. Ibrahim Masoodi
  1. Internal Medicine, Yenepoya Medical College, Mangalore, Karnataka, India
  1. Correspondence to Dr Rohith George; rohit.salim07{at}


Being a region endemic for leprosy, clinical practitioners in India often encounter myriad manifestations and diverse complications of the disease. However, the masking of the obvious clinical presentations due to the coexistence of a closely resembling unrelated disorder, a ‘mimicker’, would indeed pose a serious diagnostic predicament unless a high degree of clinical suspicion is maintained. Leprosy, also known as Hansen’s disease is a chronic infectious disease caused by Mycobacterium leprae complex that involves the skin and peripheral nerves. Neurofibromatosis type 1 (NF1) also known as von Recklinghausen’s disease is an autosomal dominant genetic disorder that presents with skin changes and benign peripheral nerve sheath tumours called neurofibromas. Here, we present the case of a 35-year-old man with NF1 who presented with type 2 lepra reaction (erythema nodosum leprosum, ENL) and the skin biopsy unmasked ENL nodule among the group of NF1 nodules.

  • tropical medicine (infectious disease)
  • public health

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  • Contributors RG has managed the case, performed the literature search, wrote the article and is the guarantor. SD identified the case for publication. IM aided in management of the case and edited the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.