Fogagnolo Letícia, de Souza Elemir Macedo, Cintra Maria Letícia, Velho Paulo Eduardo Neves Ferreira
Departments of Dermatology, Medical School, State University of Campinas.
Braz J Infect Dis. 2007 Jun;11(3):378-82. doi: 10.1590/s1413-86702007000300016.
Multibacillary, lepromatous or borderline leprosy patients may present two types of vasculonecrotic reactions: Lucio phenomenon and that associated with erythema nodosum leprosum. Despite they can be distinguished through clinical and histological characteristics; both are often used as synonyms. It is said that leprosy reaction should be properly classified for therapeutic reasons, since it is well known that in Lucio phenomenon there is not a good response to thalidomide. The authors reported two cases of vasculonecrotic phenomena in lepromatous leprosy sharing clinical and histopathological characteristics of both reaction subtypes. The findings may indicate the spectral nature of the reaction phenomena in leprosy and emphasize the importance of the clinic-pathological correlation for proper classification. Our findings may contribute to the understanding of leprosy reactions pathogenesis, broaden the knowledge about their outcome with standard treatment, and provide the scientific background to design better therapeutic strategies for these complications.
多菌型、瘤型或界线类麻风患者可能会出现两种血管坏死反应：卢西奥现象以及与麻风结节性红斑相关的反应。尽管它们可通过临床和组织学特征加以区分，但二者常被用作同义词。据说，出于治疗原因，麻风反应应进行恰当分类，因为众所周知，在卢西奥现象中，沙利度胺并无良好疗效。作者报告了两例瘤型麻风血管坏死现象，兼具两种反应亚型的临床和组织病理学特征。这些发现可能表明麻风反应现象具有光谱性质，并强调临床病理相关性对于恰当分类的重要性。我们的发现可能有助于理解麻风反应的发病机制，拓宽对其标准治疗结果的认识，并为设计针对这些并发症的更好治疗策略提供科学依据。
