Abstract
Lucio's phenomenon is a variant of erythema nodosum leprosum characterized by serious cutaneous necrotizing reaction. Herein we report on a 46-year-old male patient complaining of multiple purpuric skin lesions and fever for 3 days. Medical history revealed previous clinical diagnosis of lepromatous leprosy (LL) and Lucio's phenomenon. Dermatologic examination showed nodular infiltration of face, madarosis, erythematous macules, and necrotic ulcerations on the upper and lower limbs. Oral examination revealed multiple ulcers on the upper lip and tongue. Skin biopsy showed necrotizing vasculitis, and tongue biopsy revealed hyperplastic epithelium with submucosa infiltrated by many foamy macrophages with intact bacilli and globi. Mycobacterium leprae DNA was identified by PCR. Final diagnosis was LL and Lucio's phenomenon, and the patient started multidrug therapy for LL, prednisone and thalidomide for the Lucio's phenomenon. This case demonstrates that LL and Lucio's phenomenon can affect the oral cavity, underscoring the importance of evaluating oral mucosa for the diagnosis.
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