Anais Brasileiros de Dermatologia
On-line version ISSN 1806-4841
HELMER, Karin Adriane et al. The Lucio's phenomenon (necrotizing erythema) in pregnancy. An. Bras. Dermatol. [online]. 2004, vol.79, n.2, pp. 205-210. ISSN 1806-4841. http://dx.doi.org/10.1590/S0365-05962004000200009.
The Lucio's phenomenon, a type 2 reactional condition in leprosy probably mediated by immune complexes, is a severe necrotizing skin reaction that occurs mainly in patients with non-nodular lepromatous leprosy. This report presents a 27-year-old woman, in her 32nd week of pregnancy, with a one-week history of painful skin lesions in extremities, reddish-purple, sharply delineated, confluent, with bullae and occasional necrosis and ulceration. The patient also referred fever. Baciloscopy showed acid-fast bacilli and globi, and the histopathologic findings of a skin biopsy were consistent with lepromatous leprosy and Lucio's phenomenon. Prednisone and multidrug therapy with rifampin, clofazimine and dapsone were given, with remission. Pregnancy has been associated with a high incidence of first diagnosis of leprosy or with an exacerbation of symptoms in patients with the established disease because hormonal alterations cause immunological imbalance, particularly between the last three months of pregnancy and the first three months of lactation, when immunosuppression is higher. Despite the recommendation not to take drugs during pregnancy, the multidrug therapy regimen must be used, since the benefits achieved with the treatment surpass the risks.
Keywords : erythema; pregnancy; leprosy.