Tuberculoid leprosy presenting as a “racket” lesion

Abstract

The "racket" lesion is a rare presentation of tuberculoid leprosy, which consists of a thickened nerve branch emerging from a tuberculoid plaque. It results from centripetal damage to cutaneous nerves caused by granuloma formation. We describe a typical case of tuberculoid leprosy presenting as a "racket" lesion. The lesion persisted after treatment with paucibacillary multidrug therapy.

Leprosy: A clinical review

“…Symmetric nerve trunk involvement occurs, although asymmetric involvement is possible and may be the only clinical manifestation of the disease. In the area near the plaque lesion, neural thickening of the underlying nerve trunk ("Racket Sign") may occur, 27 and in the lesions themselves or in the nerve tracts with total loss of sensation, anhidrosis and/or alopecia. 16 Alteration in sensitivity tends to follow an evolutionary order: (1) altered thermal sensitivity; (2) painful and (3) tactile.…”