Lucio’s Phenomenon Mimicking Vasculitis in an Elderly Patient: A Hansen’s Reaction

Authors

  • Maria Paula Meireles Fenelon Hospital Universitário de Brasília – Clínica Médica
  • Vanessa Santos Canossa De-Felice Hospital Universitário de Brasília – Clínica Médica
  • Luciano Pires Vilanova Hospital Universitário de Brasília – Clínica Médica
  • Marco Polo Dias Freitas Hospital Universitário de Brasília – Geriatria

DOI:

https://doi.org/10.5935/2764-734X.e20250868

Keywords:

Leprosy/Immunology, Vasculitis, Aged, Case Reports

Abstract

Lucio’s phenomenon is a subtype of Virchowian leprosy characterized by necrotizing vasculitis of small vessels, which can mimic other vasculitides, particularly in the elderly. We describe the case of a 74-year-old man with a 12-month history of distal painful paresthesias and purpuric lesions on his legs and feet that progressed to necrotic ulcers. He also presented with nasal septum perforation with crusted lesions associated with madarosis and hypertrophy of the earlobes. Initial diagnostic hypotheses favored possible vasculitides. However, Lucio’s phenomenon was defined based on biopsies of skin lesions and a smear of elbows which revealed a high bacillary load. Immunosenescence can alter the clinical expression of leprosy, making this diagnosis more challenging. Nonetheless, it should always be remembered before the introduction of immunosuppressive therapies.

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Published

2025-09-12

How to Cite

Fenelon, M. P. M., De-Felice, V. S. C., Vilanova, L. P., & Freitas, M. P. D. (2025). Lucio’s Phenomenon Mimicking Vasculitis in an Elderly Patient: A Hansen’s Reaction. Infections in Evidence, 4, e20250868. https://doi.org/10.5935/2764-734X.e20250868

Issue

Vol. 4 (2025)

Section

Case Reports

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