Erythema nodosum leprosum limited to sun-exposed sites: An unusual presentation of type 2 lepra reaction

The distribution of erythema nodosum leprosum lesions limited to sun-exposed sites is an unusual presentation of a type 2 reaction. We report the case of a 23-year-old female who presented with erythematous papules, nodules and plaques confined to sun-exposed areas over the face, extensor aspect of both arms and forearms, and “V” of chest with fever and joint pains as well as ulnar clawing of the left hand. A diagnosis of type 2 lepra reaction was made which was confirmed by slit skin smear and skin biopsy.