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Two cases of tuberculoid leprosy who developed erythema multiforme bullosum (EMB) due to Dapsone (DDS) is reported. Burning and itching sensations were found to be the prominent prodromal symptoms. The patients gave history of urticaria and bronchial asthma.

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The classic iris lesions in a patient with erythema multiforme bullosum were reproduced grossly as well as microscopically by the intradermal injection of a variety of heat-killed, Gram-negative bacteria, as well as their common endotoxin, lipopolysaccharide W. In vitro exposure of the patient's blood to these antigens induced specific fibrin microclots characteristic of a hypersensitivity state. It is possible that some cases of erythema multiforme associated with a variety of respiratory, gastrointestinal, or urinary tract infections may represent a single specific delayed sensitivity reaction to the bacterial endotoxin, lipopolysaccharide.

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A case of Erythema Multiforme Bullosum in patient of lepromatous leprosy with pulmonary tuberculosis due to Rifampicin is described. It is stressed that ethambutol may act as a trigger factor to the toxic effects of Rifampicin.

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