Introduction:
Pure neuritic leprosy as a distinct type of leprosy is recognized only under Indian Association of Leprologist’s classification. It includes leprosy cases affecting peripheral nerves without any skin lesions.[1] Type 1 reactions (reversal reactions) in leprosy patients present as increased inflammation of preexisting lesions, appearance of new erythematous lesions, facial and pedal edema and even neuritis.[2] Occurrence of type 1 reaction is not common in pure neuritic leprosy. Whenever it occurs, it usually manifests as increased intensity of neuritis and nerve function impairment. However, new skin lesion as manifestation of reactional state is unusual. [3] We present a case of an adult female diagnosed with pure neuritic leprosy, who later developed type 1 reaction in the form of neuritis, pedal edema and appearance of erythematous and edematous new skin lesion over the left cheek. Type 1 reaction was confirmed by histopathology and patient was successfully managed with WHO MB-MDT and oral corticosteroids.