Drs. Shahin, Yousef, Niazy, Attia, Elmasry, Shalaby, Abdelkader, and Abdel-Halim as well as Ms. Teleb, Ms. Elbendary, Mr. Mourad, and Mr. Hamed are from the Kasr Al Aini Hospital, Faculty of Medicine, Cairo University, Egypt. Drs. Shahin, Niazy, and Attia as well as Ms. Teleb and Mr. Hamed are from the Department of Rheumatology and Rehabilitation. Drs. Yousef, Elmasry, Shalaby, Abdelkader, and Abdel-Halim as well as Ms. Elbendary and Mr. Mourad are from the Department of Dermatology. Dr. Hussein is from Al Kalaa Leprosarium Hospital, Cairo. Ms. Bahgat is from Al Omrania Leprosarium Hospital, Giza, Egypt.
Cutis. 2021 Dec;108(6):E4-E8. doi: 10.12788/cutis.0417.
Lucio phenomenon, or Lucio leprosy, is a rare severe lepra reaction that develops exclusively in patients with diffuse nonnodular lepromatous leprosy. It is characterized by irregular, angulated, or stellar necrotizing purpuric lesions that develop ulcerations. It mainly involves the extremities and develops as a result of massive invasion of vascular endothelial cells with lepra bacilli and secondary thrombotic vascular occlusion. Antiphospholipid antibodies often are detected in cases of Lucio phenomenon, and they are thought to play a role in its pathogenesis. We report a case of diffuse lepromatous leprosy in Egypt in which Lucio phenomenon with scrotal involvement and positive antiphospholipid antibodies was the first diagnostic presentation. The patient showed an excellent response to a combination of antileprotic treatment, low dose of prednisolone, acetylsalicylic acid, and anticoagulants. In addition, surgical debridement and vacuum therapy were performed for the scrotal lesion. Awareness of this grave presentation of leprosy is important for both dermatologists and rheumatologists to avoid misdiagnosis as vasculitis/collagen disease.
卢西奥现象，又称卢西奥麻风，是一种罕见的严重麻风反应，仅发生于弥漫性结节性麻风患者。其特征为无规则、角状或星状坏死性紫斑性皮损，并发展为溃疡。主要累及四肢，由麻风杆菌大量侵袭血管内皮细胞，继发血栓性血管闭塞引起。卢西奥现象患者常检测到抗磷脂抗体，其被认为在发病机制中起作用。我们报告了埃及一例弥漫性瘤型麻风病例，其首发表现为卢西奥现象伴阴囊受累和抗磷脂抗体阳性。患者对联合抗麻风治疗、小剂量泼尼松龙、乙酰水杨酸和抗凝剂治疗反应良好。此外，对阴囊病变进行了清创术和负压治疗。皮肤科医生和风湿病医生都需要认识到这种严重的麻风表现，以避免误诊为血管炎/胶原病。
