Lucio´s phenomenon as a presentation of Hansen disease
Abstract
Introduction: Hansen disease is a chronic infectious disease caused by Mycobacterium leprae, which mainly affects the skin and peripheral nerves. Leprosy reactions are acute events associated to an increase in the morbimortality of the disease.
Objective: the study aims to present the clinical case of patient with Lucio´s phenomenon, which allowed the diagnosis of Hansen disease, and to emphasize on the importance of having this disease in mind for an appropriate diagnosis, despite it being rather unusual in our country.
Discussion: Lucio´s phenomenon is a kind of leprosy reaction mediated by immune complexes. Clinically, it is characterized by the sudden onset of macules or blue hemorrhagic plaques, with a rapid evolution to necrotic ulcers, and it heals leaving star-shaped atrophic scars. If it is not treated, it may be fatal due to superinfection and sepsis. Treatment is based on specific medication for the infection, associated to prednisone and the correct handling of injuries.
References
2) Maymone MBC, Laughter M, Venkatesh S, Dacso MM, Rao PN, Stryjewska BM, et al. Leprosy: clinical aspects and diagnostic techniques. J Am Acad Dermatol 2020; 83(1):1-14.
3) Flageul B. Lèpre. Maladie de Hansen. EMC Dermatologie 2010; 98-370-A-10.
4) Global leprosy (Hansen disease) update, 2019: time to step-up prevention initiatives. Wkly Epidemiol Rec 2020; 95(46):417-40. Disponible en: https://www.who.int/publications/i/item/who-wer9536 [Consulta: 15 set 2021].
5) Vázquez FA, Turcatti E, Carrau G, Falco S. Reseña de las actividades de control de la enfermedad de Hansen en el Uruguay y su situación epidemiológica a diciembre de 2002. Biomedicina 2006; 2(2):155-68.
6) Comisión Honoraria para la Lucha Antituberculosa y Enfermedades Prevalentes. Programa Post-eliminación de la Enfermedad de Hansen. Montevideo: CHLA-EP, 2004.
7) Eichelmann K, González González SE, Salas-Alanis JC, Ocampo-Candiani J. Lepra: puesta al día. Definición, patogénesis, clasificación, diagnóstico y tratamiento. Actas Dermosifiliogr 2012; 104(7):554-63.
8) Maymone MBC, Venkatesh S, Laughter M, Abdat R, Hugh J, Dacso MM, et al. Leprosy: treatment and management of complications. J Am Acad Dermatol 2020; 83(1):17-30.
9) Dermatología. XI Congreso Internacional de Lepra. (Ciudad de México 13-18 nov 1978). Rev Mex 1978; XXII(2):91-182.
10) Rocha RH, Emerich PS, Diniz LM, Oliveira MB, Cabral AN, Amaral AC. Lucio’s phenomenon: exuberant case report and review of Brazilian cases. An Bras Dermatol 2016; 91(5 suppl 1):60-3.
11) Aldama A, Wattiez V, Mendoza G. Fenómeno de Lucio. Comunicación de 14 casos. Piel 2018; 33(2):81-5.
12) Kamath S, Vaccaro SA, Rea TH, Ochoa MT. Recognizing and managing the immunologic reactions in leprosy. J Am Acad Dermatol 2014; 71(4):795-803.
13) Monteiro R, Abreu MA, Tiezzi MG, Roncada EV, Oliveira CC, Ortigosa LC. Lucio’s phenomenon: another case reported in Brazil. An Bras Dermatol 2012; 87(2):296-300.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.