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Two cases of borderline-tuberculoid leprosy which developed keratosis spinulosa over the anaesthetic areas alone during type I lepra reactions are described. Both patients only developed spiny papules during the period of reaction and subsided with control of the reaction. The probable mechanism of this peculiar phenomenon might be due to the generation of epidermal growth factors by local T cell activation during the type I lepra reaction.

Keratosis spinulosa developing in borderline-tuberculoid lesions during type I lepra reaction: two case reports