Lucio's phenomenon: a report of three cases seen in Johor, Malaysia.
BACKGROUND
Lucio's phenomenon is a rare and aggressive necrotising variant of erythema nodosum leprosum that classically occur in patients with undiagnosed, diffuse non-nodular lepromatous leprosy. It is a potentially fatal leprosy reaction characterised by extensive, bizarrely-shaped, painful purpuric skin lesions and ulcerations. Lucio's phenomenon is very rarely reported outside of Mexico and Costa Rica.


METHODS
We describe 3 cases seen in Johor, Malaysia.


RESULTS
The first two cases responded to the prompt simultaneous institution of daily rifampicin, dapsone, clofazimine and prednisolone. Case 3 continued to have new lesions and extension of existing lesions while on dapsone and clofazimine. The subsequent addition of rifampicin and prednisolone prevented new lesion formation but patient succumbed to the extensive cutaneous infarcts and consequent sepsis.


CONCLUSIONS
Early diagnosis and prompt institution of multi-drug therapy together with prednisolone may improve the prognosis and outcome of Lucio's phenomenon.
Choon
Siew Eng
SE
Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia. ricardo.galimberti@hospitalitaliano.org.ar
Tey
Kwee Eng
KE
D000328:Adult; D004893:Erythema Nodosum / Q000473:pathology*; D005260:Female; D006801:Humans; D015440:Leprosy, Lepromatous / Q000473:pathology*; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D055815:Young Adult