Lucio’s phenomenon: report of five cases

Abstract

The different clinical forms of leprosy are mainly related to the variety of immunological responses to the infection. Several forms of lepromatous leprosy are recognized, including macular, nodular, and diffuse. Lucio's phenomenon is a rare but distinctive skin eruption seen in patients with diffuse lepromatous leprosy. The diffuse lesions of Lucio's phenomenon have a predilection for the extremities, can include nodules, and heal with atrophic stellate scars; histologically, a necrotizing vasculitis accompanied by a nonspecific inflammatory reaction may be seen. Because of its rarity and similarity with some manifestations of the rheumatic disease and other causes of vasculitis, Lucio's phenomenon may not be easily recognized, especially in non-endemic countries, which leads to confusing diagnosis and loss of time for treatment. We report five patients with vasculitis caused by Lucio's phenomenon.

Lucio Phenomenon: Sequelae of Neglected Leprosy

“…Hansen bacilli. 4) The predilection of the diffuse lesion in the Lucio phenomenon is mainly extremities, which may include nodules and heal with atrophic stellate scars, as seen in our patient. 4) In a series of 30 patients studied by Rea and Jerskey, 8) only four were diagnosed with leprosy before the development of the Lucio phenomenon.…”

“…4) The predilection of the diffuse lesion in the Lucio phenomenon is mainly extremities, which may include nodules and heal with atrophic stellate scars, as seen in our patient. 4) In a series of 30 patients studied by Rea and Jerskey, 8) only four were diagnosed with leprosy before the development of the Lucio phenomenon. It may not be easily recognized because of its rarity in non-endemic countries, as well as its similarity with some other manifestations of rheumatic disease and other causes of vasculitis.…”

“…It may not be easily recognized because of its rarity in non-endemic countries, as well as its similarity with some other manifestations of rheumatic disease and other causes of vasculitis. 4) In a study conducted in Malaysia involving 27 cases between 2008-2013, Kwan et al 9) reported that up to 44% of cases seen initially in a primary care setup were misdiagnosed. Our patient was treated as having a fungal in- Leprosy Strategy.…”

“…1) However, sporadic cases have been reported in Brazil, Argentina, India, and Singapore. [2][3][4]6) To the best of our knowledge, the first Lucio phenomenon case series in Malaysia was reported in 2009, where one out of three patients succumbed to the disease. 1) Our patient, an Indonesian, has been a resident of Malaysia for the past 33 years and survived the ordeal.…”

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) .…”