The clinical diagnosis of lepra type 1 reaction was confirmed by examination of biopsy specimen taken from two sites, face and leg, which showed edematous dermis with perivascular, periadnexal and interstitial lymphohistiocytic infiltrate along with few epitheloid histiocytes. The infiltrates were encroaching the arrector pili muscles and destructing nerve bundles. Stain for acid fast bacilli (lepra) was negative. (figure 3a,b,c)