2. This large paucibacillary (PB) patch was originally almost flat, but has become swollen, and red, especially round the edges, due to Type 1 reaction. As seen here, the skin manifestations are striking and often lead to recognition and treatment of this complication in leprosy, but the possibility of nerve damage, with involvement of hands, feet or eyes, is even more important. If available, reaction cases are often better treated in a referral centre, but consult your national guidelines with regard to the immediate treatment of mild or severe cases. Type 1 reaction.
