View source for Diffuse leprosy of Lucio and Latapí

{{short description|Clinical variety of lepromatous leprosy}}
The '''diffuse leprosy of Lucio and Latapí''', also known as '''diffuse lepromatous leprosy''' or '''"pretty leprosy"''', is a clinical variety of [[lepromatous leprosy]]. It was first described by [[Rafael Lucio Nájera|Lucio]] and Alvarado in 1852 and re-identified by [[Fernando Latapi|Latapí]] in 1936. It is common in [[Mexico]] (23% of leprosy cases) and in [[Costa Rica]] and very rare in other countries.
== History ==
The spotted or lazarine leprosy was first described by Ladislao de la Pascua in 1844.<ref name="Vargas-Ocampo2007">{{cite journal|author=Vargas-Ocampo F|year=2007|title=Diffuse leprosy of Lucio and Latapí: a histologic study|journal=Leprosy Review|volume=78|issue=3|pages=248–260|doi=10.47276/lr.78.3.248|doi-access=free|pmid=18035776}}</ref> Lucio and Alvarado published a description of the disease with the same names in 1852. Latapí re-described it in 1938 and reported it as 'spotted' leprosy of Lucio in 1948. It was named the diffuse leprosy of Lucio and Latapí in 1963 by Frenken.
The underlying pathology was explained by Chévez-Zamora as a diffuse generalised cutaneous infiltration. He named it pure and primitive diffuse lepromatosis, upon which necrotising lesions develop. He proposed the name ''{{lang|es|Fenómeno de Lucio}}'' or ''{{lang|es|erythema necrotisans}}'' for these lesions.
== Clinical features ==
This condition is characterized by:<ref name="Saúl1983">{{cite journal|author1=Saúl A|author2=Novales J|year=1983|title=Lucio-Latapí leprosy and the Lucio phenomenon|language=French|journal=Acta Leprologica|volume=1|issue=3|pages=115–132|pmid=6359800}}</ref>
* a diffuse infiltration of all the skin which never transforms into nodule
* a complete alopecia of eyebrows and eyelashes and body hair
* an [[Hypohidrosis|anhydrotic]] and [[Dysesthesia|dysesthetic]] zones of the skin
* a peculiar type of lepra reaction named [[Lucio's phenomenon]] or necrotic [[erythema]]
Lucio's phenomenon consists of well-shaped erythematous spots which later become necrotic with scabs, ulcerations and scars. These lesions are usually located on the lower extremities and may be extensive. They are frequently painful and rarely fatal.
== Pathology ==
The main pathological features of this disease are a [[Cutaneous small-vessel vasculitis|vasculitis]] affecting all cutaneous vessels.
There are by five characteristic features:<ref name="Vargas-Ocampo2007"/>
* colonisation of endothelial cells by acid-fast bacilli
* endothelial proliferation and marked thickening of vessel walls to the point of obliteration
* [[angiogenesis]]
* vascular [[ectasia]]
* thrombosis of the superficial and mid-dermal blood vessels
The likely pathogenesis is endothelial cell injury due to colonization/invasion followed by proliferation, angiogenesis, thrombosis and vessel ectasia.
==Treatment==
Lucio's phenomenon is treated by anti-leprosy therapy ([[dapsone]], [[rifampin]], and [[clofazimine]]), optimal [[wound care]], and treatment for [[bacteremia]] including [[antibiotics]]. In severe cases [[exchange transfusion]] may be helpful.<ref>Kasper DL, Braunwald E, Fauci AS, et al. Harrison's Principles of Internal Medicine. 16th edition. McGraw-Hill. 2005. Vol I.  p.971.  {{ISBN|0071477608}}</ref>
== References ==
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{{DEFAULTSORT:Diffuse leprosy of Lucio and Latapi}}
[[Category:Leprosy]]