A Case of Lepromatous Leprosy (Lucio's Phenomenon) Presenting as Periorbital Edema.
Journal
Ophthalmic plastic and reconstructive surgery
ISSN: 1537-2677
Titre abrégé: Ophthalmic Plast Reconstr Surg
Pays: United States
ID NLM: 8508431
Informations de publication
Date de publication:
09 May 2024
09 May 2024
Historique:
medline:
10
5
2024
pubmed:
10
5
2024
entrez:
9
5
2024
Statut:
aheadofprint
Résumé
Despite low prevalence of leprosy worldwide, new cases continue to present and require swift evaluation and diagnosis to prevent complications. Here, we describe a case of lepromatous leprosy with Lucio's phenomenon initially presenting with facial and periorbital edema. A 38-year-old Brazilian woman presented to the emergency department with facial swelling and erythema, initially treated as cellulitis. Due to rapid worsening despite broad-spectrum antibiotics, she underwent soft tissue exploration and biopsy due to concern for necrotizing fasciitis. During her course, she also developed retiform purpura of bilateral upper and lower extremities. Periorbital and lower extremity pathological specimens ultimately revealed acid-fast bacilli consistent with Mycobacterium leprae, and the patient improved with multidrug therapy. This case illustrates the diagnostic difficulty of lepromatous leprosy with Lucio's phenomenon, which can initially present with periorbital edema.
Identifiants
pubmed: 38722767
doi: 10.1097/IOP.0000000000002645
pii: 00002341-990000000-00392
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
Déclaration de conflit d'intérêts
The authors have no financial or conflicts of interest to disclose.
Références
Han XY, Sizer KC, Thompson EJ, et al. Comparative sequence analysis of Mycobacterium leprae and the new leprosy-causing Mycobacterium lepromatosis. J Bacteriol 2009;191:6067–6074.
Legendre DP, Muzny CA, Swiatlo E. Hansen’s disease (Leprosy): current and future pharmacotherapy and treatment of disease-related immunologic reactions. Pharmacotherapy 2012;32:27–37.
Truman RW, Singh P, Sharma R, et al. Probable zoonotic leprosy in the southern United States. N Engl J Med 2011;364:1626–1633.
Bhandari J, Awais M, Robbins BA, Gupta V. Leprosy. StatPearls. Publishing. 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK559307/
Hogeweg M, Keunen JE. Prevention of blindness in leprosy and the role of the Vision 2020 Programme. Eye (Lond) 2005;19:1099–1105.
Organization WH. Global leprosy (Hansen disease) update, 2022: new paradigm - control to elimination. Wkly Epidemiol Rec 2023;37:409–429.
Bhukhan A, Dunn C, Nathoo R. Case report of leprosy in Central Florida, USA, 2022. Emerg Infect Dis 2023;29:1698–1700.
Ridley DS. Histological classification and the immunological spectrum of leprosy. Bull World Health Organ 1974;51:451–465.
Ridley DS, Jopling WH. Classification of leprosy according to immunity: a five-group system. Int J Lepr Other Mycobact Dis 1966;34:255–273.
Rodrigues Junior IA, Gresta LT, Noviello Mde L, et al. Leprosy classification methods: a comparative study in a referral center in Brazil. Int J Infect Dis 2016;45:118–122.
Kamath S, Vaccaro SA, Rea TH, et al. Recognizing and managing the immunologic reactions in leprosy. J Am Acad Dermatol 2014;71:795–803.
Antunes DE, Santos DF, Lima MIS, et al. Clinical, epidemiological, and laboratory prognostic factors in patients with leprosy reactions: a 10-year retrospective cohort study. Front Med (Lausanne) 2022;9:841030.
Guiterrez-Villarreal IM, Ocampo-Candiani J, Villarreal-Martinez A, et al. Leprosy reactions after SARS-COV2 (COVID-19) infection. J Eur Acad Dermatol Venereol 2023;37:e952–e954.
Aponso S, Hoou LC, Wei YY, et al. Multibacillary leprosy unmasked by COVID-19 vaccination. JAAD Case Rep 2022;19:87–89.
Soshamma G, Suryawanshi N. Eye lesions in leprosy. Lepr Rev 1989;60:33–38.
Pavezzi PD, do Prado RB, Boin Filho PA, et al. Evaluation of ocular involvement in patients with Hansen’s disease. PLoS NeglTrop Dis 2020;14:e0008585.
Ffytche TJ. Ocular leprosy. Trop Doct 1985;15:118–125.
Chandra Sekhar G, Vance G, Otton S, et al. Ocular manifestations of Hansen’s disease. Doc Ophthalmol 1994;87:211–221.
Guimarães FC, Cruz AAV. Eyelid changes in long-standing leprosy. Ophthal Plast Reconstr Surg 1998;14:239–243.
Nijland HM, Ruslami R, Suroto AJ, et al. Rifampicin reduces plasma concentrations of moxifloxacin in patients with tuberculosis. Clin Infect Dis 2007;45:1001–1007.
Iqbal O, Langford MP, Flowers AB, et al. Bilateral ptosis/blepharitis due to lepromatous leprosy. Am J Ophthalmol Case Rep 2022;25:101236.
Sarkar D, Chawla H, Singh P, et al. Case of leprosy mimicking preseptal cellulitis: a diagnostic dilemma. BMJ Case Rep 2022;15:e245641.
Fernandes TR, Brandao GA, Castro e Souza B. Leprosy type-I reaction episode mimicking facial cellulitis--the importance of early diagnosis. An Bras Dermatol 2015;90:73–76.
Rea TH, Levan NE. Lucio’s phenomenon and diffuse nonnodular lepromatous leprosy. Arch Dermatol 1978;114:1023–1028.
Curi PF, Villaroel JS, Migliore N, et al. Lucio’s phenomenon: report of five cases. Clin Rheumatol 2016;35:1397–1401.
Arvieux J, Renaudineau Y, Mane I, et al. Distinguishing features of Anti-β2 glycoprotein I antibodies between patients with leprosy and the antiphospholipid syndrome. Thromb Haemost 2002;87:599–605.
de Larrañaga G, Forastiero R, Martinuzzo M, et al. High prevalence of antiphospholipid antibodies in leprosy: evaluation of antigen reactivity. Lupus 2000;9:594–600.
Daniel E, Ffytche TJ, Kempen JH, et al. Incidence of ocular complications in patients with multibacillary leprosy after completion of a 2 year course of multidrug therapy. Br J Ophthalmol 2006;90:949–954.
Parikh R, Thomas S, Muliyil J, et al. Ocular manifestation in treated multibacillary Hansen’s disease. Ophthalmology 2009;116:2051–7.e1.
Dos Santos AR, Silva PRS, Steinmann P, et al. Disability progression among leprosy patients released from treatment: a survival analysis. Infect Dis Poverty. 2020;9:53.
Aubry A, Sammarco Rosa P, Chauffour A, et al. Drug resistance in leprosy: an update following 70 years of chemotherapy. Infect Dis Now 2022;52:243–251.
Santos VS, Quintans-Junior LJ, Barboza WS, et al. Clinical characteristics and outcomes in patients with COVID-19 and leprosy. J Eur Acad Dermatol Venereol 2021;35:e1–e2.