Leprosy with necrosis in granulomatous reaction.

Case 1: A 43 year-old, white man presented with a four month-history of six plaques well-circumscribed. Laboratory results, including several serological tests, as well as a radiological investigation, were either negative or normal. The Mitsuda reaction was positive (9 mm). He was put on prednisone therapy and multi-drug therapy (MDT) with subsequent healing of the cutaneous lesions and improvement of the neuritis in about six months. The diagnostic hypothesis was reactional tuberculoid leprosy (Figure 1).