Lucio's phenomenon/erythema necroticans

Sehgal, Virendra

doi:10.1111/j.1365-4632.2005.02567.x

Cited by 40 publications

(21 citation statements)

References 23 publications

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“…The most notable clinical feature of DLL and Lucio's phenomenon is the diffuse mycobacterial invasion of endothelial cells surrounding small vessels, often leading to vascular occlusion (8). The initial cyanotic lesions, caused by poor blood supply and ischemia, gradually evolve into black necrotic lesions (11,12). Hence, these cases are often associated with long-term morbidity (8) as well as a higher number of fatalities if not managed adequately (5, 13).…”

mentioning

confidence: 99%

Insight into the evolution and origin of leprosy bacilli from the genome sequence of Mycobacterium lepromatosis

Singh

Benjak

Schuenemann

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

150

135

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Mycobacterium lepromatosis is an uncultured human pathogen associated with diffuse lepromatous leprosy and a reactional state known as Lucio's phenomenon. By using deep sequencing with and without DNA enrichment, we obtained the near-complete genome sequence of M. lepromatosis present in a skin biopsy from a Mexican patient, and compared it with that of Mycobacterium leprae, which has undergone extensive reductive evolution. The genomes display extensive synteny and are similar in size (∼3.27 Mb). Protein-coding genes share 93% nucleotide sequence identity, whereas pseudogenes are only 82% identical. The events that led to pseudogenization of 50% of the genome likely occurred before divergence from their most recent common ancestor (MRCA), and both M. lepromatosis and M. leprae have since accumulated new pseudogenes or acquired specific deletions. Functional comparisons suggest that M. lepromatosis has lost several enzymes required for amino acid synthesis whereas M. leprae has a defective heme pathway. M. lepromatosis has retained all functions required to infect the Schwann cells of the peripheral nervous system and therefore may also be neuropathogenic. A phylogeographic survey of 227 leprosy biopsies by differential PCR revealed that 221 contained M. leprae whereas only six, all from Mexico, harbored M. lepromatosis. Phylogenetic comparisons indicate that M. lepromatosis is closer than M. leprae to the MRCA, and a Bayesian dating analysis suggests that they diverged from their MRCA approximately 13.9 Mya. Thus, despite their ancient separation, the two leprosy bacilli are remarkably conserved and still cause similar pathologic conditions. Mycobacterium lepromatosis | genome sequencing | Mycobacterium leprae | comparative genomics | reductive evolution

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confidence: 99%

Insight into the evolution and origin of leprosy bacilli from the genome sequence of Mycobacterium lepromatosis

Singh

Benjak

Schuenemann

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

150

135

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

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confidence: 99%

Bullous Erythema Nodosum as Initial Manifestation of Leprosy

Moura¹,

Sampaio²,

Góes³

et al. 2017

BJMHH

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Introduction: Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae with protean manifestations, particularly prone to affect skin and peripheral nerves. The natural course of the disease may be associated with the development of type 1 or type 2 immunologic reactions. These immunologic reactions are reported to be caused by increased activity of the immune system, particularly a cell-mediated immune response against live leprosy bacillus or remnants of dead bacilli. Leprosy is one of the oldest diseases of mankind. Its clinical diagnosis can be challenging due to the varied manifestations. The first description of bullous erythema nodosum was made 1898 and since then there are few recorded reports. Case Report: Here we present a case of bullous erythema nodosum as leprosy first manifestation. A 35 year-woman presented with 1-year history of disseminated blisters on trunk, forearms and thighs, and multiple painful ulcerated nodules on her face. She reported that the lesions in her face became eroded and ulcerated spontaneously. There were no thickened nerves. Blood and Histopathological investigations were made. The treatment instituted was prednisone 1mg/kg without thalidomide. After two weeks with excellent response, specific therapy for Mycobacterium leprae was initiated by the infectious diseases assistant physician with a satisfactory response.

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“…LP primarily affects LL and BL patients, particularly those of Latin ancestry (Costa Rica and Mexico) (Donner & Shively 1967). However, cases outside Central America were reported on the West Coast of the United States of America, in South America and in Africa (Sehgal 2005).…”

Section: T2r -mentioning

confidence: 99%