6. Lepra reactionsThe chronic granulomatous disease is occasionally complicated by acute exacerbational states termed as Lepra Reactions. The type I Lepra reaction is usually not associated with systemic features. Type 2 Lepra reaction (ENL) Erythema Nodosom Leprosom is usually associated with constitutional symptoms like fever, joint pains and systemic complications involving various structures like eye (Iridocyclitis) ENT (Epistaxis), Pleurisy, pericarditis - ECG changes, hepatitis, acute glomerulo nephritis, arthritis, tenosynovitis and dactylitis. (See Chapter on Leprosy).