Lucio’S Phenomenon
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2021 ◽  
Vol 0 ◽  
pp. 1-14
Marco Andrey Cipriani Frade ◽  
Pedro S. Coltro ◽  
Fred Bernardes Filho ◽  
Grazielle S. Horácio ◽  
Antônio A. Neto ◽  

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.

Shahrizan Majid Binti Allapitchai

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, predominantly affecting the skin and peripheral nerves. Lucio phenomenon is a rare reactional state presenting in patient with lepromatous leprosy and described as acute cutaneous necrotising vasculitis. We discussed the case of a 38-year-old male patient presenting with oedematous and dusky discolouration of bilateral hands and feet associated with diffuse facial involvement. His skin condition gradually worsened to form multiple ulcers with bizarre shaped purpuric lesion over bilateral upper and lower limbs, trunk, and face. Histopathological examination of the skin biopsy showed multiple acid-fast bacilli and diagnosis of Lucio’s phenomenon was made in the background of lepromatous leprosy. He was treated with multi drug therapy (MDT) as recommended by the WHO guidelines. A better understanding of rarer manifestation of this illness is important for early diagnosis and to prevent significant morbidity associated with it.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S20

2021 ◽  
Vol 384 (17) ◽  
pp. 1646-1646
Mahroo Tajalli ◽  
Carlos G. Wambier

Eduardo Vinicius Mendes Roncada ◽  
Isabella Andrade Marques ◽  
Marilda Aparecida Milanez Morgado de Abreu

Sri Menaldi ◽  
Melani Marissa ◽  
Inadia Chairista ◽  
Henry Lim ◽  
Rahadi Rihatmadja

2020 ◽  
Vol 13 (3) ◽  
pp. 288-294
Dwi Sepfourteen ◽  
Tutty Ariani

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.

2019 ◽  
Vol 19 (1) ◽  
Denis Miyashiro ◽  
Carolina Cardona ◽  
Neusa Yuriko Sakai Valente ◽  
João Avancini ◽  
Gil Benard ◽  

Abstract Background Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae. It is a polymorphic disease with a wide range of cutaneous and neural manifestations. Ulcer is not a common feature in leprosy patients, except during reactional states, Lucio’s phenomenon (LP), or secondary to neuropathies. Cases presentation We report eight patients with multibacillary leprosy who presented specific skin ulcers as part of their main leprosy manifestation. Ulcers were mostly present on lower limbs (eight patients), followed by the upper limbs (three patients), and the abdomen (one patient). Mean time from onset of skin ulcers to diagnosis of leprosy was 17.4 months: all patients were either misdiagnosed or had delayed diagnosis, with seven of them presenting grade 2 disability by the time of the diagnosis. Reactional states, LP or neuropathy as potential causes of ulcers were ruled out. Biopsy of the ulcer was available in seven patients: histopathology showed mild to moderate lympho-histiocytic infiltrate with vacuolized histiocytes and intact isolated and grouped acid-fast bacilli. Eosinophils, vasculitis, vasculopathy or signs of chronic venous insufficiency were not observed. Skin lesions improved rapidly after multidrug therapy, without any concomitant specific treatment for ulcers. Conclusions This series of cases highlights the importance of recognizing ulcers as a specific cutaneous manifestation of leprosy, allowing diagnosis and treatment of the disease, and therefore avoiding development of disabilities and persistence of the transmission chain of M. leprae.

2019 ◽  
Vol 6 (2) ◽  
pp. 15 ◽  
Gustavo Alexis Lemus-Barrios ◽  
Julian Andrés Hoyos-Pulgarín ◽  
Carlos Eduardo Jimenez-Canizales ◽  
Diana Melisa Hidalgo-Zambrano ◽  
Fredy Escobar-Montealegre ◽  

Introduction: Leprosy is a chronic, multisystemic granulomatous infection caused by Mycobacterium leprae. Lucio’s phenomenon is an uncommon reaction consisting of a severe chronic necrotizing vasculitis. The purpose of this article is to present two cases of Lucio’s phenomenon and a review of the literature on its clinical presentation and management.Case Presentation: Two middle-aged men presented with ulcers and ecchymosis in lower extremities, with simultaneous peripheral nerve damage and leonine facies. Both were treated according to World Health Organization recommendations, with a favorable clinical response.Discussion: The clinical characteristics presented in this article make part of the classical description. A proper history and physical examination allowed for a correct diagnostic approach and prompt confirmation of diagnosis, despite the unspecific nature of these signs and symptoms.Conclusions: Leprosy and Lucio’s phenomenon are infrequent conditions that are difficult to diagnose. We suspect this condition to be under-registered. Awareness and a high clinical suspicion are necessary in endemic regions.

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