Atopic Dermatitis: a Short Summary
- Rare variant of lepromatous leprosy usually found in Mexico and Costa Rica. Also detected in Canada, Singapore, Brazil and Myanmar.
- Historical facts:
- described in 1852 by Lucio and Alvarado
- Etiology
- All described cases of Lucio’s phenomenon were caused by Mycobacterium lepromatosis which is more frequent in lepromatous leprosy and is the most common type of Leprosy in Mexico.
- Microscopically, it is a form of vasculitis: more exactly a necrotizing variant of erythema nodosum leprosum (ENL) (this was found in 1948 by Latapi and Zamora)
- Presentation:
- It occurs 1 to 3 years after the onset of leprosy
- On the face:
- Infiltrated shiny skin on the face can be seen – it is also also called Lepra Bonita (Pretty Leprosy) (Described by Latapi in 1936)
- Madarosis=loss of eyebrows
- this leads early phase to a disappearance of wrinkles (Pretty Leprosy). In later stages, the skin becomes sagging and wrinkled.
- It can be preceded by livedo reticularis which can be anywhere but which is more frequent on the lower legs which can lead afterwards to ulcers with a jagged (reticulated) border. Ulcers take 1-2 months to heal with MDT and heal with atrophic scars.
- polyneuropathy and destructive rhinitis are common
- hand and feet can be puffy and swollen
Contributors
Dr Christophe Hsu – dermatologist. Geneva, Switzerland
Eng CS. Lucio Leprosy – Revisited. Leprosy and other Mycobacteriosis – Status Update. 2014 (4) – 21st Regional Conference of Dermatology; Danang (Vietnam)
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