Sporotrichoid presentations in leprosy

Two adult patients of leprosy, one woman and one man, presented with a clin ical picture simulating sporotrichosis. The skin and regional nerve trunk w as affected in one, and in the other the disease was confined to the nerve. Both had features of an upgrading reaction following anti-leprosy therapy; this was seen as erosion and scarring of the plaque, and acute onset of ab scesses along the easily palpable and thickened nerve that ruptured through the skin. The diagnosis was supported by histopathology. In the light of o ther infections that give rise to a sporotrichoid pattern of infection it i s concluded that leprosy should also be included in this category so that e arly diagnosis and use of corticosteroids can be implemented quickly to pre vent nerve destruction.