01627nas a2200145   4500000000100000008004100001260001600042100001200058245005500070856016700125300001100292490000700303520115700310022001401467       2020                            d  bElsevier BV1 aRosli N00aLucio’s phenomenon in untreated advanced leprosy  uhttps://reader.elsevier.com/reader/sd/pii/S2214330020300626?token=E069C1A734C8F502F22A1EB8EDB956080B49EF15C5AB69B2C7F85C45DA8A29FE5FCD206A1719CC8D95A523F6C58936F3  a2004130 v213 aA 77-year-old woman with underlying diabetes mellitus, hypertension and Parkinson disease presented to the emergency department with burn injury after dipping her foot into hot water. She was admitted with 75% dermal thickness burn of bilateral foot. On examination, she was noted to have extensive purpuric patches with livedo reticularis. Further examination revealed leonine facies, madarosis and hypoaesthesia of the lower limbs. Slit skin smear exhibit bacillary index of 3.5 (moderate acid-fast bacteria present). Skin biopsy showed perivascular lymphocytic and foamy histiocytic inflammation with vascular thrombosis (Fig. 1; H&E, 100×) and presence of acid-fast bacilli (Fig. 2; Ziehl-Neelsen stain, 400×), features that are consistent with lepromatous leprosy with Lucio’s phenomenon. This patient was started on antileprosy multidrug therapy (clofazimine, rifampicin and dapsone). However, she developed multiple ulcers, pressure sores and had recurrent infections while in ward stay that required multiple antibiotics regime and daily dressing. She succumbed 3 months following admission due to septic shock secondary to infected ulcers.  a2214-3300