Diffuse Multibacillary Leprosy of Lucio and Latapí with Lucio’s Phenomenon, Peru
Cesar Ramal
, Martin Casapia, Johan Marin, Juan C. Celis, Jorge Baldeon, Stalin Vilcarromero, Guillermo Cubas, Alex Espejo, Francisco Bravo, Oswaldo V. Paredes, Jose M. Ramos, and Pedro Legua
Author affiliations: Loreto Regional Hospital, Iquitos, Peru (C. Ramal, M. Casapia, J. Marin, J.C. Celis, J. Baldeon, G. Cubas, A. Espejo, O.V. Paredes); National University of the Peruvian Amazon, Iquitos (C. Ramal, M. Casapia, J. Baldeon); U.S. Naval Medical Research Unit 6 (NAMRU-6), Iquitos (S. Vilcarromero); Cayetano Heredia National Hospital, Lima, Peru (F. Bravo, P. Legua); Alicante University General Hospital. Alicante, Spain (J.M. Ramos)
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Figure
Figure. Diffuse multibacillary leprosy of Lucio and Latapí with Lucio’s phenomenon in a 65-year-old man in Peru. A) Vasculitis with necrosis of the superficial vascular plexus. Forearms and dorsum of hands show papulonodular dermotoses infiltrating erythematous lesions (white arrows). B) Patches of scaling skin or necrotic eschar on feet. C) Skin biopsy of leg (hematoxylin and eosin stain, original magnification ×40) showing largely unremarkable epidermis but collection of foamy histiocytes in dermis (arrow). D) Fite-Faraco staining (original magnification ×400) clearly shows large quantity of bacilli (arrows) in the foamy histiocytes, consistent with the theory of infectious vasculitis being an etiopathogenic mechanism of Lucio’s phenomenon.
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