Magaña Mario, Vargas Bornacini María Fernanda, Landeta-Sa Ana Paula, Aguilar-Mena Cristina
Dermatologists Service of Dermatology "Dr. Mario Magaña Lozano" of the Hospital General de México "Dr. Eduardo Liceaga", S. S./Faculty of Medicine, UNAM, Mexico City, México.
Universidad Anáhuac México, Estado de México, México; and.
Am J Dermatopathol. 2025 Jan 1;47(1):1-8. doi: 10.1097/DAD.0000000000002833. Epub 2024 Sep 17.
Mycobacterium leprae and M. lepromatosis, the causative agents of leprosy, have left a mark on human history. Despite advances in health care, leprosy continues to affect millions worldwide, often leading to complications, mostly neural, due to delayed diagnosis and treatment. This persisting prevalence emphasizes the need for continued research and effective management strategies. Leprosy presents in many forms, mainly lepromatous and tuberculoid, influenced by the patient's immunological status and exhibits specific clinical characteristics. Studies have shown that Mycobacterium lepromatosis is frequently associated with the lepromatous forms of the disease, characterized by generalized skin lesions and systemic involvement. This connection has led to the distinction of M. lepromatosis as the main cause of Lucio Leprosy and Lucio phenomenon (LPh); this last one is an immune-mediated response, including necrotizing panvasculitis and systemic manifestations. Once considered endemic to Mexico and Central America, migration expanded its geographical reach. Triggers include infections and certain medical conditions. Histopathologically, LPh represents a necrotizing panvasculitis, ischemic necrosis, and the presence of immune components in small vessels. Diagnosis relies on clinical characteristics and histopathological findings. Treatment lacks standardization; however, effective management involves antileprosy medication and systemic glucocorticoids. In conclusion, the historical impact of leprosy and LPh persists in medical discussions. Prevention, early diagnosis, and treatment challenges continue, necessitating ongoing research to improve patient outcomes and bring down this health concern.
麻风分枝杆菌和利氏曼原虫是麻风病的病原体，在人类历史上留下了印记。尽管医疗保健有所进步，但麻风病仍在影响着全球数百万人，由于诊断和治疗延误，常常导致并发症，主要是神经方面的并发症。这种持续的流行情况凸显了持续研究和有效管理策略的必要性。麻风病有多种表现形式，主要是瘤型和结核样型，受患者免疫状态影响，并具有特定的临床特征。研究表明，利氏曼原虫常与该疾病的瘤型相关，其特征为全身性皮肤病变和全身受累。这种关联导致利氏曼原虫被认定为卢西奥麻风病和卢西奥现象（LPh）的主要病因；后者是一种免疫介导的反应，包括坏死性全血管炎和全身表现。曾经被认为是墨西哥和中美洲的地方病，移民扩大了其地理范围。触发因素包括感染和某些医疗状况。组织病理学上，LPh表现为坏死性全血管炎、缺血性坏死以及小血管中存在免疫成分。诊断依赖于临床特征和组织病理学发现。治疗缺乏标准化；然而，有效的管理包括抗麻风病药物和全身性糖皮质激素。总之，麻风病和LPh的历史影响在医学讨论中仍然存在。预防、早期诊断和治疗挑战依然存在，需要持续开展研究以改善患者预后并降低这一健康问题的影响。
