{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:47:22Z","timestamp":1785937642637,"version":"3.56.0"},"reference-count":11,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Retiform purpura is a morphological pattern that is a clinical reflection of microvascular occlusion. Although several infectious etiologies are described, leprosy remains an underrecognized cause. Lucio phenomenon is a rare vasculonecrotic reaction of untreated lepromatous leprosy, characterized by endothelial invasion by\n                    <jats:italic>Mycobacterium leprae<\/jats:italic>\n                    (\n                    <jats:italic>M. leprae<\/jats:italic>\n                    ), leading to thrombosis and necrotizing vasculitic skin lesions. The present report involves a case of a 70-year-old woman who presented with purpuric and necrotic lesions over the extremities, digital discoloration, and neuritic pain, with a history of spontaneous autoamputation of digits a decade earlier. An examination revealed stellate purpura, hemorrhagic bullae, glove-and-stocking anesthesia, lagophthalmos, madarosis, and thickened peripheral nerves. Coagulation parameters were deranged, and IgM anti-\u03b22-glycoprotein and anticardiolipin antibody test results were positive. A slit-skin smear revealed a bacteriological index of 5+. Histopathology revealed foamy histiocytes, with vasculitis, leukocytoclasia, and Fite-positive bacilli infiltrating the vessel walls. Polymerase chain reaction testing confirmed\n                    <jats:italic>M. leprae<\/jats:italic>\n                    . A diagnosis of lepromatous leprosy with microvascular occlusion secondary to the Lucio phenomenon was made. Prompt initiation of multidrug therapy and anticoagulation led to rapid recovery. Early recognition is essential to prevent irreversible tissue loss, especially in leprosy endemic countries, and is possibly an important cause of imported infectious disease in developed countries.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.26-0147","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T13:59:20Z","timestamp":1782827960000},"page":"250-253","source":"Crossref","is-referenced-by-count":0,"title":["Retiform Purpura Due to Microvascular Occlusion: An Archetypical Manifestation of Lucio Phenomenon in Lepromatous Leprosy"],"prefix":"10.4269","volume":"115","author":[{"given":"Savitha","family":"Sharath","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Research Institute and Dr Ram Manohar Lohia Hospital, New Delhi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kabir","family":"Sardana","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Research Institute and Dr Ram Manohar Lohia Hospital, New Delhi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinav","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Research Institute and Dr Ram Manohar Lohia Hospital, New Delhi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Ahuja","sequence":"additional","affiliation":[{"name":"Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Research Institute and Dr Ram Manohar Lohia Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Adv Dermatol","first-page":"3","article-title":"The differential diagnosis of purpura from a morphologic perspective","volume":"9","author":"Piette","year":"1994"},{"issue":"3","key":"b2","series-title":"Dermatol Rep","first-page":"10173","article-title":"Lucio phenomenon: A case report on an overlooked reaction in lepromatous leprosy","volume":"17","author":"Sajjachareonpong","year":"2025"},{"issue":"1","key":"b3","series-title":"Indian J Med Res","first-page":"5","article-title":"Misdiagnosis of leprosy: An underappreciated reason for its continued prevalence","volume":"161","author":"Sardana","year":"2025"},{"issue":"5","key":"b4","series-title":"Clin Rheumatol","first-page":"1397","article-title":"Lucio\u2019s phenomenon: Report of five cases","volume":"35","author":"Curi","year":"2016"},{"issue":"3","key":"b5","series-title":"Lepr 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non-bilayer lipid arrangements containing mycolic acids","volume":"107","author":"Baeza","year":"2012"},{"issue":"8","key":"b10","series-title":"Lupus","first-page":"594","article-title":"High prevalence of antiphospholipid antibodies in leprosy: Evaluation of antigen reactivity","volume":"9","author":"de Larra\u00f1aga","year":"2000"},{"issue":"3","key":"b11","series-title":"PLoS Negl Trop Dis","first-page":"e0006214","article-title":"Blood coagulation abnormalities in multibacillary leprosy patients","volume":"12","author":"da Silva","year":"2018"}],"container-title":["The American Journal of Tropical Medicine and 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