[Lucio phenomenon. Vasculitis or occlusive vasculopathy?].
Lucio's phenomenon (LP) occurs in patients with Lucio leprosy (LuL). Some interpret the cutaneous lesions and their histopathology as a thrombotic/occlusive condition, while others consider it leukocytoclastic vasculitis. The clinical similarities between the cutaneous manifestations of LP and antiphospholipid syndrome (APS) led us to investigate the relationship between these two pathological conditions. We studied the clinical, laboratory and histopathologic aspects of LuL and LP in one patient and compare these results to APS. The examination of antiphospholipid antibodies showed positive anticardiolipin (aCL) and lupus anticoagulant (LAC). The histopathological slides of cutaneous biopsies were stained by hematoxylin-eosin and Fite-Faraco. They showed the typical features of LuL, as well as thrombi, endothelial proliferation, vessel wall thickening and obliteration of the lumen. Leukocytoclastic vasculitis was not found. The clinical pattern of LuL in our case is identical to that described by Lucio and Latapi. The necrotic lesions of LP in our patient resembled APS. This suggests that LP could be considered APS secondary to LuL. Multidrug treatment for multibacillary patients (MDT-MP) was successful, with no need for thalidomide or systemic corticosteroids.
Institut für Dermatologie Prof. R.D. Azulay, Santa Casa da Misericórdia, Rio de Janeiro.
L
L
Azulay-Abulafia
L
L
Pereira Spinelli
D
D
Hardmann
B
B
Kawa Kac
R A
RA
Levy
C
C
Talhari
T
T
Ruzicka
D001157:Arterial Occlusive Diseases / Q000145:classification / Q000175:diagnosis*; D001168:Arthritis / Q000145:classification / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D015440:Leprosy, Lepromatous / Q000145:classification / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012883:Skin Ulcer / Q000145:classification / Q000175:diagnosis*; D013577:Syndrome; D014657:Vasculitis / Q000145:classification / Q000175:diagnosis*