Leper reactions simulating cutaneous vasculitis Report of 3 cases and literature review
Abstract
Leprosy is a chronic infectious disease with a broad spectrum of clinical manifestations. Luciophenomenon and necrotic erythema nodosum leprosum are two vasculonecrotic reactions that can mimic cutaneous vasculitis in leprosy. Although they can be distinguished through clinical and histopathological features, both are often used as synonyms. Lucio Phenomenon, a severe immunecomplex mediated skin reaction, is a necrotizing skin condition that occurs in patients with non-nodular or diffuse leprosy which occurs in patients with little or no resistance to infection. Vasculonecrotic reactions due to erythema nodosum occur in other forms of leprosy different from the diffuse form.
We present the case of 3 patients with lepromatous leprosy who presented vasculonecrotic reactions. The differential diagnosis between Lucio phenomenon and necrotic erythema nodosum leprosum is important since both entities have different treatments. In a patient with cutaneous vasculitic lesions, infectious etiologies including leprosy, should always be considered.
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References
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