Diffuse leprosy of Lucio and Latapí
Encyclopedia
The diffuse leprosy
of Lucio
and Lapatí, also known as diffuse lepromatous leprosy or "pretty leprosy" is a clinical variety of lepromatous leprosy
. It was first described by Lucio and Alvarado in 1852 and re-identified by Latapí in 1936. It is common in Mexico
(23% leprosy cases) and in Costa Rica
and very rare in other countries.
The underlying pathology was explained by Chévez-Zamora as a diffuse generalised cutaneous infiltration. He named it pure and primitive diffuse lepromatosis, upon which necrotising lesions develop. He proposed the name Fenómeno de Lucio or erythema necrotisans for these lesions.
Lucio's phenomenon consists of well-shaped erythematous spots which later become necrotic with scabs, ulcerations and scars. These lesion usually on the lower extremities and may be extensive They are frequently painful. Rarely it may be fatal.
There are by five characteristic features:
The likely pathogensis is endothelial cell injury due to colonization/invasion followed by proliferation, angiogensis, thrombosis and vessel ectasia.
including antibiotics. In severe cases exchange transfusion
may be helpful.
Leprosy
Leprosy or Hansen's disease is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis. Named after physician Gerhard Armauer Hansen, leprosy is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions...
of Lucio
Lucio
Lucio is an Italian, Portuguese, Spanish male given name derived from Latin name Lucius. Lucio is also an Italian, Portuguese and Spanish surname.It may be refer to:People* Lucio Amanti , a Canadian cellist...
and Lapatí, also known as diffuse lepromatous leprosy or "pretty leprosy" is a clinical variety of lepromatous leprosy
Lepromatous leprosy
Lepromatous leprosy is a skin condition consisting of pale macules.It results from the failure of Th1 cell activation which is necessary to eradicate the parasite....
. It was first described by Lucio and Alvarado in 1852 and re-identified by Latapí in 1936. It is common in Mexico
Mexico
The United Mexican States , commonly known as Mexico , is a federal constitutional republic in North America. It is bordered on the north by the United States; on the south and west by the Pacific Ocean; on the southeast by Guatemala, Belize, and the Caribbean Sea; and on the east by the Gulf of...
(23% leprosy cases) and in Costa Rica
Costa Rica
Costa Rica , officially the Republic of Costa Rica is a multilingual, multiethnic and multicultural country in Central America, bordered by Nicaragua to the north, Panama to the southeast, the Pacific Ocean to the west and the Caribbean Sea to the east....
and very rare in other countries.
History
The spotted or lazarine leprosy was first described by Ladislao de la Pascua in 1844. Lucio and Alvarado published a description of the disease with the same names in 1852. Latapí re-described it in 1938 and reported it as 'spotted' leprosy of Lucio in 1948. It was named the diffuse leprosy of Lucio and Latapí in 1963 by Frenken.The underlying pathology was explained by Chévez-Zamora as a diffuse generalised cutaneous infiltration. He named it pure and primitive diffuse lepromatosis, upon which necrotising lesions develop. He proposed the name Fenómeno de Lucio or erythema necrotisans for these lesions.
Clinical features
This condition is characterized by:- a diffuse infiltration of all the skin which never transforms into nodule
- a complete alopecia of eyebrows and eyelashes and body hair
- an anhydrotic and dysesthesic zones of the skin
- a peculiar type of lepra reaction named Lucio's phenomenonLucio's phenomenonLucio's phenomenon is an unusual reaction seen almost exclusively in patients from the Caribbean and Mexico with diffuse, lepromatous leprosy, especially in untreated cases...
or necrotic erythema
Lucio's phenomenon consists of well-shaped erythematous spots which later become necrotic with scabs, ulcerations and scars. These lesion usually on the lower extremities and may be extensive They are frequently painful. Rarely it may be fatal.
Pathology
The main pathological features of this disease are a vasculitis affecting all cutaneous vessels.There are by five characteristic features:
- colonisation of endothelial cells by acid-fast bacilli
- endothelial proliferation and marked thickening of vessel walls to the point of obliteration
- angiogenesis
- vascular ectasia
- thrombosis of the superficial and mid-dermal blood vessels
The likely pathogensis is endothelial cell injury due to colonization/invasion followed by proliferation, angiogensis, thrombosis and vessel ectasia.
Treatment
Lucio's phenomenon is treated by anti-leprosy therapy (dapsone, rifampin, and clofazimine), optimal wound care, and treatment for bacteremiaBacteremia
Bacteremia is the presence of bacteria in the blood. The blood is normally a sterile environment, so the detection of bacteria in the blood is always abnormal....
including antibiotics. In severe cases exchange transfusion
Exchange transfusion
An exchange transfusion is a medical treatment in which apheresis is used to remove one person's red blood cells or platelets and replace them with transfused blood products...
may be helpful.