Lucio’s phenomenon in a non-endemic region: A case report

Abstract

Leprosy remains a persistent health challenge in endemic regions with cases rising in non-endemic regions such as North America. Patients with leprosy present with a variety of symptoms including limited skin lesions in tuberculoid leprosy to extensive lesions and high bacterial proliferation in lepromatous leprosy. This case report details a 77-year-old Canadian man of South Asian descent with lepromatous leprosy and Lucio’s phenomenon in Western Canada. The patient exhibited widespread retiform purpura on the limbs with localized ulcerations, erosions, and necrosis on the left hand and feet, peripheral neuropathy, and digit shortening. Histopathological examination and PCR confirmed Mycobacterium leprae . Management involved a 24-month multidrug therapy, leading to significant symptom reduction. This report highlights the diagnostic challenges of leprosy in non-endemic regions and the importance of a multidisciplinary approach for accurate diagnosis and treatment.