Lucio’s leprosy: A clinical and therapeutic challenge

Bullous Erythema Nodosum as Initial Manifestation of Leprosy

“…Although the presence of bullous lesions is well-documented in the rare Lucio's phenomenon/ Erythema necroticans, this spectrum of lesion is even more uncommon in the classical ENL [4][5][6] . Probably the first description of bullous erythema nodosum was made by Gibb & Aberd in 1898 7 and since then there are few countable recorded reports.…”

“…It is characterized by systemic manifestations like arthralgia, fever, iridocyclitis, nephritis, myositis and lymphadenitis associated with eruption of numerous disseminated painful nodules characterized by erythema nodosum (EN) 1,2 . Although EN is considered the typical lesion of T2R, it may mimic diverse other clinical conditions, and in such cases, delays in diagnosis are commonly observed [3][4][5][6][7][8][9][10] . Bullous Erythema Nodosum Leprosum (BENL) is a subset of EN wich is a subset of EN which is manifested as disseminated bullous reactions.…”

Hansen’s disease with Lucio’s phenomenon in a country in the post elimination era: A case report

“…[7] There are three types of reactions that affect 30% to 50% of patients with Leprosy: type 1 reaction or reversible reaction; type 2 or Erythema Nodoso Leprosum (ENL) and the third or Lucio's phenomenon that was initially described in 1852 by Rafael Lucio, in collaboration with Alvarado in the work titled "Booklet on the Evil of San Lázaro or Elefanciasis of the Greeks". [7,8] The latter is relatively rare and there are no descriptions in Colombia about it, as a reference in South America, in Brazil approximately 11 cases have been reported since 2000. [6] Lucio's phenomenon is almost exclusively limited to Mexican and Central American patients, although it is rarely reported in South America especially in Colombia.…”

“…[6] Taking into account that Colombia leprosy was considered eliminated (with a prevalence of less than 1 case per 10,000 inhabitants since 1997), and considering that the country is in a post-elimination phase, it is quite rare to find such cases, as well as the previously presented. [2,9] The Lucio's phenomenon corresponds to a necrotizing vas-culitis with microscopic thrombosis and is one of the clinical manifestations of lepromatous leprosy, [8] requires for its diagnosis to document the presence of multibacillary leprosy and the histopathological diagnosis of necrotizing vasculitis in patients without visceral symptoms with painful plaques or nodules that tend to ulcerate, who generally have not received treatment. [6,7,9,10] This usually starts in the feet and advances cephaladically towards the hands, back and face, initially the lesions debut as erythematous macules of different sizes and shapes, which evolve at 24 to 48 hours, and on the third and fourth day to dark purpurical lesions that end in small blisters due to central necrosis, nevertheless, our case presented in the latter phase with necrosis of the fleshy parts of the distal phalanges.…”

Reacciones lepromatosas en pacientes adultos y pediátricos en un centro de referencia. Programa Nacional de Lepra, Paraguay

“…Si durante la reacción hay compromiso nervioso, la descompresión quirúrgica del nervio puede estar indicada. La talidomida es de utilidad sólo para tratar la reacción leprosa tipo 2 (13)(14)(15)(16)(17)(18)(19) .…”