Lucio phenomenon and Lucio leprosy

Abstract

Lucio phenomenon is a peculiar reactional state associated with Lucio leprosy; both exhibit a restricted global distribution. The exact underlying pathomechanism of Lucio phenomenon, which may be fatal at times, still needs further elaboration. A case of relapse of partially treated nodular lepromatous leprosy presenting with Lucio phenomenon is reported, along with a brief review of the literature.

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.…”

Analysis of the Leprosy Agents Mycobacterium leprae and Mycobacterium lepromatosis in Four Countries

“…This form of leprosy shows a diffuse cutaneous infiltrate, with no nodule or plaque formation and frequent skin ulceration in the late stage. DLL is predominantly seen in patients from western and central Mexico and the Caribbean countries, 10,15,16 but rare cases have been reported elsewhere, including Asia (India, Iran, Malaysia, and Singapore), [17][18][19][20][21] the Pacific (Hawaii), 22 Europe (France), 23 North America (United States), 24 South America (Brazil), 25,26 and northern Africa (Tunisia). 27 All these reports were based on the clinical and pathologic features prior to recognition of M lepromatosis.…”

Diffuse Multibacillary Leprosy of Lucio and Latapí with Lucio’s Phenomenon, Peru

“…Initially described by Lucio and Alvarado in 1852 in Mexico, Lucio’s phenomenon was so named in 1948 by Latapí and Zamoro ( 3 ). This reaction is seen in patients who have pure and primitive nonnodular lepromatous leprosy (diffuse leprosy of Lucio and Latapí [ 4 ]). This clinical variety of leprosy is most commonly found in Mexico and Central America ( 5 – 7 ) and is rarely described outside these regions ( 8 – 10 ).…”

“…It develops as a result of exacerbated proliferation of leprosy bacilli, which invade the walls of the blood vessels and the endothelial cells, causing endothelial proliferation and reduction of the vascular lumen. These effects, together with the inflammatory reaction and the changes in the coagulation system, lead to vascular thrombosis, ischemia, infarction, and necrosis of the tissues, giving rise to the histopathological features of the phenomenon ( 4 , 6 ). …”