01971nas a2200301   4500000000100000008004100001260001200042100001300054700001300067700001400080700001200094700001200106700001400118700001400132700001700146700001300163700001200176700001600188700001300204700001200217700001800229245013600247856007900383300001000462490000800472520117500480022001401655       2021                            d  c12/20211 aShahin A1 aYousef R1 aHussein S1 aNiazy M1 aAttia D1 aElmasry M1 aShalaby S1 aAbdelkader H1 aBahgat M1 aTeleb D1 aElbendary A1 aMourad A1 aHamed S1 aAbdel-Halim M00aWidespread Necrotizing Purpura and Lucio Phenomenon as the First Diagnostic Presentation of Diffuse Nonnodular Lepromatous Leprosy.  uhttps://cdn.mdedge.com/files/s3fs-public/issues/articles/ct108006004_e.pdf  aE4-E80 v1083 a<p>Lucio phenomenon, or Lucio leprosy, is a rare severe lepra reaction that develops exclusively in patients with diffuse nonnodular lepromatous leprosy. It is characterized by irregular, angulated, or stellar necrotizing purpuric lesions that develop ulcerations. It mainly involves the extremities and develops as a result of massive invasion of vascular endothelial cells with lepra bacilli and secondary thrombotic vascular occlusion. Antiphospholipid antibodies often are detected in cases of Lucio phenomenon, and they are thought to play a role in its pathogenesis. We report a case of diffuse lepromatous leprosy in Egypt in which Lucio phenomenon with scrotal involvement and positive antiphospholipid antibodies was the first diagnostic presentation. The patient showed an excellent response to a combination of antileprotic treatment, low dose of prednisolone, acetylsalicylic acid, and anticoagulants. In addition, surgical debridement and vacuum therapy were performed for the scrotal lesion. Awareness of this grave presentation of leprosy is important for both dermatologists and rheumatologists to avoid misdiagnosis as vasculitis/collagen disease.</p>
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