Classification of the lepra reaction is reviewed. The cutaneous eruptions in the form of vesicles, pustules, or necrosis are indicative of a severe form of the reaction. A case is reported in a woman who presented, for the first time, a lepra reaction. She had systemic sy mptoms, and cutaneous and mucous membrane lesions leading to palatal perforation. The rarity of lesions of this type and the difficulty in their categorization into recognized types of lepra reaction are discussed .