Clinical Outcomes of Alternative Therapy Rifampicin and Clarithromycin in a Patient with Lucio’s Phenomenon Who Declined Standard Multidrug Therapy: A Case Report
DOI:
https://doi.org/10.66344/jpad.v36i3.3518Keywords:
Lucio’s Phenomenon, Leprosy Reaction, Rifampicin, ClarithromycinAbstract
Lucio’s phenomenon (LP) is a rare reaction of lepromatous leprosy (LL) characterized by extensive skin necrosis. Standard multidrug therapy (MDT) is the mainstay of treatment, however the patient’s refusal of standard MDT may complicate management. This case report describes the management of LP using rifampicin and clarithromycin in a patient refusing standard MDT. A 66-year-old male presented with purpuric patches on the extremities and painful leg ulcers. Examination revealed leonine facies, madarosis, megalobuli, hyperpigmented purpuric macules, and multiple necrotic ulcers. Slit-skin smear showed a bacterial index of +4 and a morphological index of 7%, while histopathology confirmed LP in LL. The patient received rifampicin, clarithromycin, corticosteroids, and wound care. Marked improvement of skin lesions was observed after 3 months. Rifampicin combined with clarithromycin may be an effective alternative regimen for LP in patients who refuse standard MDT, achieving favorable clinical outcomes and improving treatment adherence.
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Copyright (c) 2026 Ivana Shafira Putri, Rika Harditawati, Elvantie
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