Hansen’s disease is a chronic infectious granulomatous condition with variable presentations, especially during lepra reactions. This report describes two atypical cases: a middle-aged male with Type 2 lepra reaction presenting with painful thigh lesions and high fever without prior multidrug therapy; and an elderly male with Type 1 lepra reaction showing raised margins over pre-existing lesions with neuritic features, also without prior multidrug therapy. © 2023 Elsevier B.V., All rights reserved.