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Case Reports
. 2013 Nov-Dec;88(6 Suppl 1):93-6.
doi: 10.1590/abd1806-4841.20132398.

Lucio's phenomenon. Case study of an exceptional response to treatment exclusively with multibacillary multidrug therapy

Amanda Braga Peixoto  1 , Poliana Santin Portela  1 , Fabiano Roberto Pereira de Carvalho Leal  2 , Arles Martins Brotas  3 , Nilton Carlos dos Santos Rodrigues  4
Affiliations
Case Reports

Lucio's phenomenon. Case study of an exceptional response to treatment exclusively with multibacillary multidrug therapy

Amanda Braga Peixoto et al. An Bras Dermatol. 2013 Nov-Dec.

Abstract
in English, Portuguese

Lucio's phenomenon represents a serious cutaneous necrotizing reaction, which can occur with Lucio's leprosy and also in other forms of lepromatous leprosy. The authors discuss the case of a 63-year-old male patient presenting with ulcers and necrotic cutaneous lesions on the limbs, torso and face, associated with recurring sinusitis, hoarseness and a weight loss of 25 kilos over the last year. Bacilloscopy of intradermal scrapings showed a bacilloscopic index of 5 and the histopathological findings were compatible with the diagnosis of Lucio's phenomenon. The chosen treatment was exclusively multibacillary multidrug therapy, resulting in important dermatological improvement after one month of therapy. The authors present an impressive case of Lucio's phenomenon with an exceptional response to treatment exclusively with multibacillary multidrug therapy.

O fenômeno de Lúcio representa uma reação cutânea necrosante grave que pode ocorrer na hanseníase de Lúcio e em outras formas de hanseníase virchowiana. Os autores relatam o caso de um paciente masculino de 63 anos de idade apresentando há um ano lesões ulceronecróticas nos membros, lóbulos auriculares e tronco, associadas a sinusite de repetição, rouquidão e perda ponderal de 25 kg. A baciloscopia de raspado intradérmico mostrou índice baciloscópico de 5 e o exame histopatologico foi compatível com fenômeno de Lúcio. O tratamento instituído foi exclusivamente com poliquimioterapia multibacilar (PQT-MB), havendo melhora importante do quadro cutâneo após um mês de tratamento. Os autores apresentam um caso exuberante de fenômeno de Lúcio que obteve excelente resposta ao tratamento somente com PQT-MB.

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Conflict of interest statement

Conflict of interest: None

Figures

FIGURE 1
FIGURE 1
Crusted ulcerated lesions mainly in the oral and nasal cavities and presence of madarosis
FIGURE 2
FIGURE 2
Converging of lesions, leaving large denuded areas
FIGURE 3
FIGURE 3
Presence of innumerous granular bacilli by the Fite-Faraco stain
FIGURE 4
FIGURE 4
Impressive recovery after one month of treatment
See this image and copyright information in PMC

References

    1. Saúde.gov.br [página da internet] Brasil. Ministério da saúde. Secretaria de Políticas de Saúde. Departamento de Atenção Básica . Guia para o controle da Hanseníase. Brasília: Ministério da Saúde; 2002. [acesso 26 jul 2012]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/guia_de_hanseniase.pdf Guideline for the control of Hanseniasis. Available in Portuguese at http://bvsms.saude.gov.br/bvs/publicacoes/guia_de_hanseniase.pdf.
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