title: Lucio's phenomenon, an uncommon occurrence among leprosy patients in Sri Lanka.
abstract: BACKGROUND
  Lucio's phenomenon is a rare manifestation of untreated leprosy which is seen almost exclusively in regions surrounding the Gulf of Mexico. Its occurrence elsewhere though documented is considered uncommon. We present a case of Lucio's phenomenon in a previously undiagnosed leprosy patient who presented to us with its classical skin manifestations.
  
  
  METHODS
  A 64 year old South Asian (Sri Lankan) male with a history of chronic obstructive airway disease presented to us with fever and cough. He had a generalized smooth and shiny skin with ulcerating skin lesions afflicting the digits of the fingers. The lesions progressed to involve the extremities of the body and healed with crusting. Based on the clinical and investigational findings Tuberculosis and common vasculitic conditions were suspected and excluded. The unusual skin manifestations prompted a biopsy, and wade fite stained revealed Mycobacterium bacilli. In context of the clinical picture and histological findings, Lucio's phenomenon was suspected. A clinical diagnosis of Lucio's phenomenon occurring in the backdrop of lepromatous leprosy was made.
  
  
  CONCLUSIONS
  Though leprosy is still a prevalent disease, it has manifestations that are not easily recognized or fully appreciated. Regional patterns of atypical manifestations should not limit better understanding of rarer manifestations as it will aid in clinching an early diagnosis and instituting prompt treatment, thereby reducing morbidity and mortality.
authors.affiliation: National Hospital of Sri Lanka, Colombo, Sri Lanka. sandaherath@yahoo.com.
authors.forename: Sandamalee
authors.initials: S
authors.lastname: Herath
authors.affiliation: National Hospital of Sri Lanka, Colombo, Sri Lanka. rayno.navinan@gmail.com.
authors.forename: Mitrakrishnan Rayno
authors.initials: MR
authors.lastname: Navinan
authors.affiliation: National Hospital of Sri Lanka, Colombo, Sri Lanka. isurujith@gmail.com.
authors.forename: Isurujith
authors.initials: I
authors.lastname: Liyanage
authors.affiliation: National Hospital of Sri Lanka, Colombo, Sri Lanka. enthusiasum@yahoo.com.
authors.forename: Nadeesha
authors.initials: N
authors.lastname: Rathnayaka
authors.affiliation: National Hospital of Sri Lanka, Colombo, Sri Lanka. yudhishdran@yahoo.com.
authors.forename: Jevon
authors.initials: J
authors.lastname: Yudhishdran
authors.affiliation: Department of Pathology, National Hospital of Sri Lanka, Colombo, Sri Lanka. janakiefernando@gmail.com.
authors.forename: Janakie
authors.initials: J
authors.lastname: Fernando
authors.affiliation: National Hospital of Sri Lanka, Colombo, Sri Lanka. gangamps@gmail.com.
authors.forename: Ganga
authors.initials: G
authors.lastname: Sirimanne
authors.affiliation: National Hospital of Sri Lanka, Colombo, Sri Lanka. kulatunga.aruna@yahoo.com.
authors.forename: Aruna
authors.initials: A
authors.lastname: Kulatunga
mesh_terms: D016523:Foot Ulcer / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D015440:Leprosy, Lepromatous / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000472:pathogenicity*; D013188:Sri Lanka