Erythema nodosum leprosum necroticans is an uncommon manifestation of type 2 lepra reaction, encountered in lepromatous and borderline lepromatous cases of leprosy. We report an unusual clinical presentation of necrotic erythema nodosum leprosum in a 9-year-old boy with no pre-existing evidence of leprosy. The lesions resolved completely following multi-bacilliary multi-drug therapy for 12 months, non-steroidal anti-inflammatory drugs and corticosteroids.