This unusual reaction is seen exclusively in
patients from the Caribbean and Mexico who have the diffuse lepromatosis form
of lepromatous leprosy, most often those who are untreated. Patients with this
reaction develop recurrent crops of large, sharply marginated, ulcerative
lesions—particularly on the lower extremities—that may be generalized and, when
so, are frequently fatal as a result of secondary infection and consequent
septic bacteremia. Histologically, the lesions are characterized by ischemic
necrosis of the epidermis and superficial dermis, heavy parasitism of
endothelial cells with AFB, and endothelial proliferation and thrombus
formation in the larger vessels of the deeper dermis. Like ENL, the Lucio
phenomenon is probably mediated by the immune complex.
Source:
Harrison_s_Principles_of_Internal_Medicine_16th_Edition
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