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Daniel SJ, Rajan M, Ruba MV, Aravamuthan R. Near fatal case of Lucio leprosy with Lucio phenomenon with pleomorphic features and its successful management from a non-endemic area. BMJ Case Rep 2024; 17:e255477. [PMID: 38955383 DOI: 10.1136/bcr-2023-255477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open
Abstract
Lucio leprosy is a diffuse non-nodular form of lepromatous leprosy. Lucio phenomenon is a type of reactional state which occurs in untreated cases due to the bacillary invasion of endothelial cells. We hereby describe a histopathologically confirmed case of Lucio leprosy with Lucio phenomenon. The patient presented with pleomorphic clinical features and started taking antileprosy treatment and systemic steroids. After few days of admission, she developed deep ulcers exposing the fascia. She also developed cardiogenic shock secondary to septicaemia. She was managed with inotropes and broad-spectrum antibiotics. The patient was given appropriate wound care and the ulcers healed within a period of 3 months and antileprosy drugs were continued. Our patient is a de novo case of Lucio leprosy with Lucio phenomenon and pleomorphic clinical features who developed near fatal septic shock. She was managed successfully. Despite the extensive disease manifestation, all the wounds healed completely.
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Affiliation(s)
- Samuel Jeyaraj Daniel
- Dermatology, Venereology and Leprosy, Madras Medical College, Chennai, Tamil Nadu, India
| | - Manipriya Rajan
- Dermatology, Venereology and Leprosy, Madras Medical College, Chennai, Tamil Nadu, India
| | - Merin Vasantha Ruba
- Dermatology, Venereology and Leprosy, Madras Medical College, Chennai, Tamil Nadu, India
| | - Ramesh Aravamuthan
- Dermatology, Venereology and Leprosy, Madras Medical College, Chennai, Tamil Nadu, India
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Rusia K, Saoji V, Madke B, Singh A. Lucio Phenomenon: An Unusual Case of Skin Necrosis. Case Rep Dermatol 2024; 16:47-54. [PMID: 38406643 PMCID: PMC10890809 DOI: 10.1159/000536370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/17/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction Lucio leprosy is a non-nodular diffuse type of lepromatous leprosy first described by Lucio and Alvarado. Lucio phenomenon is a rare vasculonecrotic reaction characterized by cutaneous necrosis with minimal constitutional features. Case Presentation We describe an unusual case of a 53-year-old man from Central India who had blisters, ulcers, and widespread erosions on his foot, forearms, and arms. The diagnosis of lepromatous leprosy with the Lucio phenomenon was established after thorough evaluation by clinical findings, histopathological findings, and slit-skin smear examination. Conclusion Lucio phenomenon is an uncommon cause of cutaneous infarction and necrosis. Primary care physicians should keep a high index of suspicion in patients with cutaneous necrosis and minimal constitution features. Since leprosy is a relatively curable disease, primary care physicians should think of a rare form of lepromatous leprosy presenting with cutaneous necrosis, especially in non-endemic zones.
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Affiliation(s)
- Kaveri Rusia
- Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, India
| | - Vikrant Saoji
- Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, India
| | - Bhushan Madke
- Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, India
| | - Adarshlata Singh
- Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, India
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Frade MAC, Coltro PS, Filho FB, Horácio GS, Neto AA, da Silva VZ, Westin AT, Guimarães FR, Innocentini LMAR, Motta ACF, Farina Junior JA. Lucio's phenomenon: A systematic literature review of definition, clinical features, histopathogenesis and management. Indian J Dermatol Venereol Leprol 2021; 88:464-477. [PMID: 34672479 DOI: 10.25259/ijdvl_909_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/01/2021] [Indexed: 11/04/2022]
Abstract
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.
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Affiliation(s)
- Marco Andrey Cipriani Frade
- Department of Medical Clinics, Division of Dermatology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Pedro S Coltro
- Department of Surgery and Anatomy, Division of Plastic Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Fred Bernardes Filho
- Department of Medical Clinics, Division of Dermatology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Grazielle S Horácio
- Department of Medical Clinics, Division of Dermatology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Antônio A Neto
- Department of Surgery and Anatomy, Division of Plastic Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Vinicius Z da Silva
- Department of Surgery and Anatomy, Division of Plastic Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Andrezza T Westin
- Department of Medical Clinics, Division of Dermatology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Francielle R Guimarães
- Department of Medical Clinics, Division of Dermatology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Lara M A R Innocentini
- Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ana C F Motta
- Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jayme A Farina Junior
- Department of Surgery and Anatomy, Division of Plastic Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
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Manejo y experiencia clínica en eritema nudoso leproso en 4 casos. Enferm Infecc Microbiol Clin 2020; 38:243-245. [DOI: 10.1016/j.eimc.2019.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 09/13/2019] [Accepted: 09/21/2019] [Indexed: 11/18/2022]
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Clinical Characteristics and Treatment of Leprosy. CURRENT TROPICAL MEDICINE REPORTS 2016. [DOI: 10.1007/s40475-016-0095-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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