[Reactional episodes in lepromatous leprosy: presentation of a clinical case]

Abstract

Objective: to present a case of lepromatous leprosy with two reactional episodes during its course.

Clinical case: 32-year-old woman from Paraguay, who presented with retiform purpura followed by ulceration on the lower limbs, associated with altered thermal and pain sensitivity. She also had skin infiltration, malar region nodules, madarosis, and a saddle nose. The diagnosis of Lucio’s phenomenon in lepromatous leprosy was made through biopsy for histopathology and bacilloscopy. She began treatment with glucocorticoids and antimicrobials according to the WHO regimen, and subsequently developed an upgrading episode with worsening of previous lesions.

Conclusion: To highlight the importance of recognizing reactional episodes in order to initiate timely treatment and thus prevent severe disabling complications.