02064nas a2200325 4500000000100000008004100001260001300042653003200055653001400087653002800101653001100129653002500140653000900165653001600174653001500190653001300205653001500218100002200233700002300255700001500278700001500293700001300308700001400321700001400335245006300349300001100412490000700423520129400430022001401724 2006 d c2006 Dec10aArterial Occlusive Diseases10aArthritis10aDiagnosis, Differential10aHumans10aLeprosy, lepromatous10aMale10aMiddle Aged10aSkin Ulcer10aSyndrome10aVasculitis1 aAzulay-Abulafia L1 aPereira Spinelli L1 aHardmann D1 aKawa Kac B1 aLevy R A1 aTalhari C1 aRuzicka T00a[Lucio phenomenon. Vasculitis or occlusive vasculopathy?]. a1101-50 v573 a

Lucio's phenomenon (LP) occurs in patients with Lucio leprosy (LuL). Some interpret the cutaneous lesions and their histopathology as a thrombotic/occlusive condition, while others consider it leukocytoclastic vasculitis. The clinical similarities between the cutaneous manifestations of LP and antiphospholipid syndrome (APS) led us to investigate the relationship between these two pathological conditions. We studied the clinical, laboratory and histopathologic aspects of LuL and LP in one patient and compare these results to APS. The examination of antiphospholipid antibodies showed positive anticardiolipin (aCL) and lupus anticoagulant (LAC). The histopathological slides of cutaneous biopsies were stained by hematoxylin-eosin and Fite-Faraco. They showed the typical features of LuL, as well as thrombi, endothelial proliferation, vessel wall thickening and obliteration of the lumen. Leukocytoclastic vasculitis was not found. The clinical pattern of LuL in our case is identical to that described by Lucio and Latapi. The necrotic lesions of LP in our patient resembled APS. This suggests that LP could be considered APS secondary to LuL. Multidrug treatment for multibacillary patients (MDT-MP) was successful, with no need for thalidomide or systemic corticosteroids.

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