Fatal Lucio's phenomenom: an autopsy case report

Abstract

The diffuse leprosy of Lucio and Alvarado is considered the most anergic spectrum of leprosy and is characterized by a generalized skin infiltration, with a diffuse and total alopecia associated with a systemic involvement. When the number of bacilli in the endothelium is high a medium and small vessel’s leukocytoclastic vasculitis develop over a diffuse and generalized cutaneous involvement by leprosy, what leads to large necrotic and ulcerative lesions, named after Lucio’s phenomenon. We present an autopsy case of a female patient who has been presenting ulcerated lesions for the last 20 years without a specific diagnosis. Three weeks before the patient’s admission the lesions got worse and new ones appeared. Due to the extension of cutaneous involvement and consequent infectious complications the patient evolved to a fatal outcome. The pathological evaluation revealed systemic involvement by leprosy and multiple skin ulceration. The cutaneous lesions were due to leukocitoclastic vasculitis and vascular occlusion, compatible with Lucio’s phenomenon .

Keywords

• Lucio’sphenomenum
• Leprosy
• Vasculitis
• Histopathology
• Necrosis.