Diffuse leprosy of Lucio and Latapí


The diffuse leprosy of Lucio and Latapí, 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 and in Costa Rica 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:
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:
The likely pathogenesis 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, optimal wound care, and treatment for bacteremia including antibiotics. In severe cases exchange transfusion may be helpful.