Clinical features of Lucio’s phenomenon (LP), shows a nectorizing erythema,
may mimicking Erythema Nodosum leprosum with vasculonecrotic. A 46 years old man
presented with diagnosis lepromatous leprosy with Lucio’s phenomenon and diferential
diagnosis borderline lepromatous (BL) with vasculonecrotic erithema nodosum leprosum. The
patients complained there were painless ulcers on his lower limbs and scrotum, with
surrounded by purpuric patches which subsequently became gangrenes and ulcerated for 3
weeks. There was numbness of both hands and feet, the eyelashes, eyebrows baldness since 5
years ago. Patient never got the treatment before. Bacteriological examination showed
bacterial index 6+ Histopathology: there were Flattened epidermis by narrow grenz zone, and
lymphocyte in perivascular with macrophage. There was endothelial proliferation of capiller.
Fite faraco stain showed macrophage infiltration around the perivasculer, with colonization of
the endothelial cell by acid fast bacilli and epidermal necrosis and diagnosis as Lepromatous
leprosy with Lucio phenomenon. This patient is given adult multiple drug therapy (MDT)
therapy, methylprednisolone, neurotrophic vitamins. Lucio’s phenomenon most commonly
affects patients with untreated leprosy. Clinically, it may be difficult to differentiate Lucio
phenomenon from Erythema nodosum leprosum with vasculonecrotic. In this case, the
histopathological examination were colonization of endothelial cell by acid fast bacilli,
epidermal necrosis and endothelial proliferation of the vessel.
Necrotic erythema nodosum reaction associated with histological alterations of Lucio’s phenomenon