Fenómeno de Lucio. Comunicación de 14 casos

Abstract

IntroductionThe Lucius Phenomenon is a severe reaction, mainly observed in diffuse lepromatous leprosy, and characterised by necrotic lesions due to vasculitis. Material and methodRetrospective study of the cases observed in the Dermatology Department of the National Hospital of Paraguay in the period 1990-2016. The study included patients of all ages, and both sexes with histological confirmation. ResultsIn the mentioned period, a total of 14 cases of Lucio's phenomenon were diagnosed during the study period, of whom 9 were male, with ages ranging from 35 to 87 years (mean 61.9 years, SD: ±14.54). All were admitted to the Hospital, 13 by the Emergency Department, and one by Dermatology. Only one patient was known to be suffering from leprosy previously, whereas in others the reaction presented led to the diagnosis of the disease. Most were lepromatous leprosy of the diffuse variety, but 5 had tuberous lesions, and in one the histological report was lepromatous borderline. Three patients died during admission, and three suffered amputation of all limbs due to overgenerated pyogenic infections. Of the 11 patients discharged, 9 successfully completed the treatment and were given high-dose therapy. Management consisted of supportive measures, treatment of complications and recurrences, multiple drug therapy specific for multibacillary leprosy. Eight patients received prednisone. ConclusionLucio's phenomenon is a serious clinical condition with a high morbidity and mortality, which must be known not only by the dermatologist but by doctors of other specialties.