Objective: It was the aim of this study to evaluate the possible role of cytology in erythema nodosum leprosum (ENL) and its use for early treatment of the disease. Study Design: We present a prospective study conducted with 15 clinically diagnosed ENL cases. Among them, 13 cases had previously been diagnosed with lepromatous leprosy (LL) and 2 patients were new LL cases with signs and symptoms of ENL lesions. Haematoxylin and eosin stain with modified Ziehl-Neelsen stain was performed on fine needle aspiration material. One case was sent for biopsy. Results: Complete cytological diagnosis of ENL was done in all 15 cases. Histopathological study revealed classical ENL lesions which also showed ENL features in cytodiagnosis. Conclusion: In the past, the accurate mode of diagnosis of ENL lesions was histopathology. However, clinicians have to wait a long time for the report and generally they start treatment only on the basis of clinical signs and symptoms. Cytodiagnosis of ENL lesions is an early, effective method for accurate diagnosis and helps to initiate treatment for these painful lesions.

1.
Singh N, Bhatia A, Gupta K, Ramam M: Cytomorphology of leprosy across the Ridley-Jopling spectrum. Acta Cytol 1996;40:719-723.
2.
Jopling WH, McDougall AC: Definition, epidemiology and world distribution; in Jopling WH, McDougall AC: Handbook of Leprosy, ed 5. New Delhi, CBS Publishers, 1996, pp 82-91.
3.
Malik A, Bhatia A, Singh N, Bhattacharya SN, Arora VK: Fine needle aspiration cytology of reactions in leprosy. Acta Cytol 1999;43:771-777.
4.
Kahawita IP, Walker SL, Lockwood DNJ: Leprosy type 1 reactions and erythema nodosum leprosum. An Bras Dermatol 2008;83:75-82.
5.
Pocaterra L, Jain S, Reddy R, Muzaffarullah S, Torres O, Suneetha S, Lockwood DNJ: Clinical course of erythema nodosum leprosum: an 11-year cohort study in Hyderabad, India. Am J Trop Med Hyg 2006;74:868-879.
6.
Cuevas J, Rodríguez-Peralto JL, Carrillo R, Contreras F: Erythema nodosum leprosum: reactional leprosy. Semin Cutan Med Surg 2007;26:126-130.
7.
Dhaliwal U, Mohanty S, Bhattacharya SN: Erythema nodosum leprosum and orbital involvement. Int J Lepr Other Mycobact Dis 2003;71:10-13.
8.
Feuth M, Brandsma JW, Faber WR, Bhattarai B, Feuth T, Anderson AM: Erythema nodosum leprosum in Nepal: a retrospective study of clinical features and response to treatment with prednisolone or thalidomide. Lepr Rev 2008;79:254-269.
9.
Ramesh V, Pahwa M: Some unusual type 2 reactions in leprosy. Int J Dermatol 2010;49:172-175.
10.
Aggarwal R, Gupta O, Beg S, Prasad R: Erythema nodosum leprosum: report of two cases. Diagn Cytopathol 2013;41:366-368.
11.
Siddaraju N, Roy SK, Bundele MM, Badhe BA, Thappa DM: Fine needle aspiration cytologic diagnosis of erythema nodosum leprosum: a case report. Acta Cytol 2007;51:800-802.
12.
Anshu , Gangane N, Vagha S, Samal N: Cytodiagnosis of erythema nodosum leprosum. A case report. Acta Cytol 2002;46:386-388.
13.
Manandhar R, LeMaster JW, Roche PW: Risk factors for erythema nodosum leprosum. Int J Lepr Other Mycobact Dis 1999;67:270-278.
14.
Nigam PK, Kumar P, Pathak N, Mittal S: Fine needle aspiration cytology in reactional and non-reactional leprosy. Indian J Dermatol Venereol Leprol 2007;73:247-249.
15.
Hastings RC, Opromolla DVA: Pathology of leprosy; in Hastings RC, Opromolla DVA (eds): Leprosy, ed 2. London, Churchill Livingstone, 1994, pp 193-224.
16.
Global strategy for further reducing the leprosy burden and sustaining leprosy control activities 2006-2010. New Delhi (India), World Health Organization, 2006-2013. http://www.who.int/lep/resources/SEAGLP20062.pdf.
17.
Guide to eliminate leprosy as public health problem. New Delhi, World Health Organization, 2006-2013. http://www.who.int/lep/resources/Guide_Int_E.pdf.
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