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

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.

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

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.

Lucio’s phenomenon: A report of two cases and review of the literature

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.