Fenômeno de Lúcio (eritema necrosante)

Abstract

A 36 six years old woman eith lepromatous leprosy has presented characteristic lesions of Lucio's Phenomenon, that evolved with necrosis and large ulcerations in her limbs and face. There was secondary infeccion, sepsis, shock, and she died after the 10th day since admission. Several venous thrombosis, broncopneumonia, foci of necrosis, and neutrophilic exsudation in lepromatous granulomata in limphnodes, and liver were observed. Findings of this necropsy and the data from literature sugest that Lucio's Phenomenon is a hemorragic inferction of cutaneus areas caused by occlusion of veins of vascular plexus of deep dermis and subcutis, previous involved by lepromatous infiltration and bacilli. Exsudative foci, observed in lepromatous granulomata in limphnodes and liver, suggests a type 2 reaction with a subclinical evolution and the exsudative alterations may be accounted for full venous occlusion. A patient with Lucia's Phenomenon is one that is similar to a patient with large bums in all his body, he has loss of water and salts, proteins and is prone to develop a bacterial infeccion in the cutaneus ulcers. Several areas of necrosis in the dermis and subcutismay release coagulation factors that cause thrombosis found in several venous territories. There is no relation between foci of necrosis in the gastrointestinal mucous membranes and Hansen's disease and they are certainly caused by shock.