Hansen's disease is a chronic granulomatous disease of infectious origin. It has 
a worldwide distribution and a variety of clinical manifestations often 
involving the skin, nasal mucosa, and peripheral nerves. Lepromatous leprosy 
characterizes the condition of a large group of patients with little or no 
resistence to the infection. Several forms of lepromatous leprosy are 
recognized, including macular, nodular, and diffuse. Lucio's phenomenon is a 
rare but distinctive skin eruption seen in patients with diffuse lepromatous 
leprosy. The diffuse lesions of Lucio's phenomenon have a predilection for the 
extremities, can include nodules, and heal with atrophic stellate scars; 
histologically, a necrotizing vasculitis accompanied by a nonspecific 
inflammatory reaction may be seen. We describe two patients with Lucio's 
phenomenon who presented with nontender, painless, skin lesions with nodules in 
part perceptible only by palpation. Both patients were treated with multidrug 
therapy, and immunosuppressive doses of steroids as the suggested optimal 
treatment for this reactional state. However, Lucio's phenomenon is frequently 
fatal as a result of bacterial infection or sepsis, and both patients reported 
here died. We call attention to this particular and unusual skin manifestation 
of lepromatous leprosy, which can mimic rheumatic disease and other causes of 
vasculitis. This is especially likely to be unrecognized in nonendemic countries 
but cases will occasionally be seen in this age of extensive international 
travel.