scholarly journals Lucio’s phenomenon: A systematic literature review of definition, clinical features, histopathogenesis and management

2021 ◽  
Vol 0 ◽  
pp. 1-14
Author(s):  
Marco Andrey Cipriani Frade ◽  
Pedro S. Coltro ◽  
Fred Bernardes Filho ◽  
Grazielle S. Horácio ◽  
Antônio A. Neto ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Literature Review ◽  
Erythema Nodosum ◽  
Clinical Laboratory ◽  
Multidrug Therapy ◽  
Review Of The Literature ◽  
Erythema Nodosum Leprosum ◽  
Clinical Presentations ◽  
Rare Manifestation ◽  
Lucio’S Phenomenon

Leprosy is a chronic disease with clinical presentations according to the immunologic spectrum. Lepromatous form is the most advanced, with the highest transmissibility and risk of causing disabilities. Lucio’s phenomenon is a rare manifestation among lepromatous patients with a rapid and severe evolution and high mortality. It is difficult to differentiate from ulcerative/necrotic erythema nodosum leprosum and has no consensus on how it should be treated. This article is a qualitative review of the literature after the introduction of multidrug therapy, aiming to bring consensus related to the clinical, laboratory and histopathological diagnostic criteria of the disease and its management.

scholarly journals Lucio Phenomenon mimicking with Vasculo necrotic Erithema Nodosum Leprosum: A Case Report

2020 ◽  
Vol 13 (3) ◽  
pp. 288-294
Author(s):  
Dwi Sepfourteen ◽  
Tutty Ariani
Keyword(s):  
Endothelial Cell ◽  
Erythema Nodosum ◽  
Lepromatous Leprosy ◽  
Lower Limbs ◽  
Acid Fast Bacilli ◽  
Erythema Nodosum Leprosum ◽  
Endothelial Proliferation ◽  
Hands And Feet ◽  
Epidermal Necrosis ◽  
Lucio’S Phenomenon

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.

Cutaneous ulceration as a presenting feature of type 1 lepra reaction: A case report

2022 ◽  
pp. 004947552110686
Author(s):  
Pallavi Hegde ◽  
Deepti Jaiswal ◽  
Varsha M Shetty ◽  
Kanthilatha Pai ◽  
Raghavendra Rao
Keyword(s):  
Case Report ◽  
Erythema Nodosum ◽  
Immunological Response ◽  
Lepromatous Leprosy ◽  
Multidrug Therapy ◽  
Cutaneous Lesions ◽  
Erythema Nodosum Leprosum

Reactions in leprosy represent sudden shift in the immunological response and are seen in 11–25% of affected patients. It can be seen before, during or after the completion of multidrug therapy (MDT). 1 Two types of reactions are recognized; Type 1 reaction (T1R), seen in borderline leprosy, affecting mainly skin and nerves; type 2 reaction (T2R) or erythema nodosum leprosum (ENL), seen in lepromatous leprosy, characterized by systemic features in addition to cutaneous lesions. Trophic ulcers and ulcerating ENL are well known entities while cutaneous ulceration in T1R is extremely rare; we describe an immune-competent woman with cutaneous ulceration as a presenting feature to highlight the need to recognize this entity at the earliest opportunity.

Erythema nodosum leprosum (type 2 reaction) in a patient with neurofibromatosis type 1

2022 ◽  
Vol 15 (1) ◽  
pp. e245174
Author(s):  
Rohith George ◽  
Sydney D'Souza ◽  
Ibrahim Masoodi
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Erythema Nodosum ◽  
Genetic Disorder ◽  
Neurofibromatosis Type ◽  
Skin Changes ◽  
Erythema Nodosum Leprosum ◽  
Clinical Presentations ◽  
High Degree

Being a region endemic for leprosy, clinical practitioners in India often encounter myriad manifestations and diverse complications of the disease. However, the masking of the obvious clinical presentations due to the coexistence of a closely resembling unrelated disorder, a ‘mimicker’, would indeed pose a serious diagnostic predicament unless a high degree of clinical suspicion is maintained. Leprosy, also known as Hansen’s disease is a chronic infectious disease caused by Mycobacterium leprae complex that involves the skin and peripheral nerves. Neurofibromatosis type 1 (NF1) also known as von Recklinghausen’s disease is an autosomal dominant genetic disorder that presents with skin changes and benign peripheral nerve sheath tumours called neurofibromas. Here, we present the case of a 35-year-old man with NF1 who presented with type 2 lepra reaction (erythema nodosum leprosum, ENL) and the skin biopsy unmasked ENL nodule among the group of NF1 nodules.

scholarly journals REACTIONAL STATES IN MULTIBACILLARY HANSEN DISEASE PATIENTS DURING MULTIDRUG THERAPY

1998 ◽  
Vol 40 (6) ◽  
pp. 363-370 ◽  
Author(s):  
José A.C. NERY ◽  
Leila M. M. VIEIRA ◽  
Haroldo J. de MATOS ◽  
Maria E. N. GALLO ◽  
Euzenir N. SARNO
Keyword(s):  
Outpatient Clinic ◽  
Erythema Nodosum ◽  
Fixed Dose ◽  
Newly Diagnosed ◽  
Multidrug Therapy ◽  
Clinical Form ◽  
Constant Attention ◽  
Erythema Nodosum Leprosum ◽  
Degree Of Disability ◽  
Reversal Reaction

It is well known that reactions are commonplace occurrences during the course of leprosy disease. Stigmatization may even be attributable to reactions which are also responsible for the worsening of neural lesions. A cohort of 162 newly-diagnosed baciloscopically positive patients from the Leprosy Care Outpatient Clinic of the Oswaldo Cruz Foundation (FIOCRUZ) was selected for this study. While 46% of the multibacillary (MB) patients submitted to the 24 fixed-dose multidrug therapy (MDT) regimen suffered reactions during treatment, it was found that all MBs were susceptible and that constant attention and care were required at all times. Fourteen per cent were classified as BB, 52% as BL, and 33% as LL. None of the variables under study, such as, sex, age, clinical form, length of illness, length of dermatological lesions, baciloscopic index (BI), or degree of disability proved to be associate with reaction among the patients studied. Reversal Reaction (RR) occurred in 45%, and Erythema Nodosum Leprosum (ENL) occurred in 55%. Among BB patients who developed reactions (15 patients), 93% presented RR; while among the LL patients who developed reactions (34 patients), 91% presented ENL. Likewise, ENL was very frequent among those with disseminate lesions, while RR was most often observed in patients with segmentary lesions. RR was also most likely to occur during the initial months of treatment. It was demonstrated that the recurrence rate of ENL was significantly higher than that of RR. Neither grade of disability nor BI was shown to be associated with RR and ENL reaction. However, the RR rate was significantly higher among patients showing BI < 3, while ENL predominated among those patients with BI > 3.

Evaluating the Connections Between Primary Care Practice and Clinical Laboratory Testing: A Review of the Literature and Call for Laboratory Involvement in the Solutions

2013 ◽  
Vol 137 (1) ◽  
pp. 120-125 ◽  
Author(s):  
Maxwell L. Smith ◽  
Stephen S. Raab ◽  
Douglas H. Fernald ◽  
Katherine A. James ◽  
Jacob A. Lebin ◽  
...  
Keyword(s):  
Primary Care ◽  
Literature Review ◽  
Primary Care Physicians ◽  
Performance Metrics ◽  
Clinical Laboratory ◽  
Laboratory Medicine ◽  
Care Practice ◽  
Evidence Based ◽  
Review Of The Literature ◽  
Patient Centeredness

Context.—Growing evidence has demonstrated a high frequency of quality gaps in laboratory medicine, with recent studies estimating that 15% to 54% of primary care medical errors reported by primary care physicians and staff are related to the testing process. However, there is lack of evidence-based performance metrics in the preanalytic and postanalytic phases of the testing pathway for primary care practices. Objective.—To use results of the literature review to assist in the development of quality indicators that could improve preanalytic and postanalytic processes in primary care–based laboratory medicine. Data Sources.—Literature in Ovid/MEDLINE from 2001 through 2011 was searched as a primary source of information. Ninety-five peer-reviewed and non–peer-reviewed publications were retrieved following title and abstract review and 10 articles were reviewed in their entirety by the authors. A systematic review of the literature was conducted regarding the connections between clinical laboratories and primary care offices and the resulting errors. Root causes of errors were categorized into 7 major themes: process failures, delays, communication gaps, errors in judgment and cognition, influence of minorities/language, practice culture, and lack of patient centeredness. Selected articles were evaluated for evidence quality using the Systematic Evidence Review and Evaluation Methods for Quality Improvement grading scale developed by the Centers for Disease Control and Prevention. Conclusions.—The focused literature review documented 7 key error themes in the laboratory medicine/primary care testing process. Performance metrics related to these themes are proposed that deserve future study for evidence-based improvement.

scholarly journals Profil Penderita Morbus Hansen (MH) di Poliklinik Kulit dan Kelamin RSUP Prof. Dr. R. D. Kandou Manado Periode Januari – Desember 2013

e-CliniC ◽  
2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Andiswati Desrina ◽  
Grace M. Kapantow ◽  
Renate T. Kandou
Keyword(s):  
Retrospective Study ◽  
Physical Disability ◽  
Erythema Nodosum ◽  
Multidrug Therapy ◽  
Erythema Nodosum Leprosum ◽  
Reversal Reaction

Abstract: Morbus Hansen (MH) is still a public, social, and rehabilitation problems due to the physical disability resulted from delayed or inadequate treatment. This study was aimed to obtain the profile of MH patients at the Dermatovenerology clinic, Prof. Dr. R. D. Kandou Hospital Manado in the period of January to December 2013. This was a descriptive and retrospective study. The results showed that there were 98 MH patients consisting of 69 males (70.4%) and 29 females (29,6%). The majority of patients were 25-44 years old (47.0%) with multibacillary type (93.9%). Most patients did not show lepra reaction (67.3%); erythema nodosum leprosum (ENL) reaction was found in 29.6% of patients, and reversal reaction in 3.1% of patients. As many of 29.6% had been treated with multidrug therapy (MDT), and 10.2% did not, meanwhile, 60,2% of patients did not have any data of treatment. In conclusion, the majority of MH patients at the Dermatovenerology clinic, Prof. Dr. R. D. Kandou Hospital Manado in the period of January to December 2013 were males, aged 25-44 years, had multibacillary type with ENL reaction, and had been treated with MDT.Keywords: Morbus Hansen profile Abstrak: Morbus Hansen (MH) masih merupakan masalah kesehatan, sosial, dan rehabilitasi oleh karena kecacatan fisik yang terjadi akibat pengobatan yang terlambat atau tidak memadai. Penelitian ini bertujuan untuk mengetahui profil penderita MH di Poliklinik Kulit dan Kelamin RSUP Prof. R. D Kandou Manado periode Januari-Desember 2013. Jenis penelitian ialah deskrip-tif retrospektif. Hasil penelitian mendapatkan 98 penderita MH (6,72%) dari total 1457 pasien, terdiri dari 69 laki-laki (70,4%) dan 29 perempuan (29,6%). Mayoritas penderita berada pada rentang usia 25-44 tahun (47,0%) dengan tipe MH multibasiler (93,9%). Pada sebagian besar pen-derita tidak didapatkan reaksi lepra (67,3%); reaksi erythema nodosum leprosum (ENL) didapatkan pada 29,6% penderita dan reaksi reversal pada 3,1% penderita. Mengenai riwayat pengobatan, sebesar 29,6% telah mendapat pengobatan multidrug therapy (MDT) sebelumnya dan 10,2% belum pernah mendapatkan pengobatan MDT, namun sebesar 60,2% penderita tidak memiliki data pengobatan. Simpulan penelitian ini ialah mayoritas penderita MH di Poliklinik Kulit dan Kelamin RSUP Prof. R. D Kandou Manado periode Januari-Desember 2013 berjenis kelamin laki-laki, usia 25-44 tahun, tipe MH multibasiler, dengan reaksi ENL, dan pernah mendapat pengobatan MDT.Kata kunci: profil Morbus Hansen

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

Erythema nodosum leprosum, wrongly diagnosed as Sweet's disease.

1989 ◽  
Vol 51 (3) ◽  
pp. 441-446 ◽  
Author(s):  
Motoaki OZAKI ◽  
Kohozou YONEDA ◽  
Keiji OHTA ◽  
Miyuki OHTA
Keyword(s):  
Erythema Nodosum ◽  
Erythema Nodosum Leprosum

Stages of the formation of temporary and permanent occlusion and the impact of early tooth extraction on the dentition state. Literature review

2019 ◽  
pp. 22-24
Author(s):  
G.A. Murachueva ◽  
I.M. Rasulov ◽  
S.G. Gusenov
Keyword(s):  
Literature Review ◽  
Temporomandibular Joint ◽  
Tooth Extraction ◽  
Physiological State ◽  
Review Of The Literature ◽  
Full Development ◽  
Permanent Occlusion ◽  
The Impact

A review of the literature on the stages of the formation of temporary and permanent occlusion has been performed. This stages play an important role not only for the full development of the maxillofacial apparatus, temporomandibular joint, but also the whole organism. The role of early tooth extraction in the formation of the physiological state of the dentoalveolar system is considered. The conclusion is drawn about the need for a deeper study of this problem in the structure of general dental morbidity.

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