SHORT CASE

 35 year old male patient, resident of ramchandrapuram ,HYD,works as daily wage labourer .

Presented with history of painless lesions - papules with erythema  that started initially over face then extended to upper limb and lower limb ,trunk since 3 months.

No fever ,no pus discharge ,no loss of sensation ,no genital lesions .

He is a chronic smoker(1 pack of beedi every 2 days )  and taking alcohol (90 ml daily ) since 20 years.

Patient got topical cream ,soap and some oral drugs from medical shop - OTC 

He used for 2 months ,few lesions regressed ,but few persisted on nose ,earlobe and on trunk ,hands ,legs .

14 days back patient developed blackish  skin discoloration over hands and feet with skin peeling ,cracking ,ulcer formation - associated with burning sensation and erythema all over the body.

No new lesions were noted .

No known comorbidities .

No history of similiar complaints in the past

On examination : 

Face - 

Loss of eye brows 

Thickened earlobe 

Multiple Papules with erythema over face ,limbs ,trunk associated with hypo pigmentation.

Diagnosis - 

Type 1 lepra reaction .