Reactive syringofibroadenoma

A 45-year-old diabetic and hypertensive man from Bihar presented with multiple, asymptomatic, elevated lesions on his right foot that developed over a period of 6 months. The lesions started developing gradually after auto-amputation of toes and have been increasing in size and thickness since then. He was treated with multi-drug therapy for Hansen's disease, 8 years before presenting to us. The further course was uneventful until he started developing auto-amputation of the toes of his right foot and he lost all of them over a period of 2 years. Cutaneous examination showed multiple, firm, slightly erythematous plaques and nodules having smooth surface, without any scaling or verrucosity, present over the distal aspect and dorsum of the right foot [Figure - 1].