Lucio's phenomenon (LPh) is considered a necrotizing panvasculitis and a variant 
of leprosy Type 2 reaction, clinically characterised by necrotic-haemorrhagic 
lesions on the extremities and trunk. LPh is observed in diffuse lepromatous 
leprosy (DLL or Lucio-Latapí leprosy). This is a distinct form of lepromatous 
leprosy (LL) reported mainly in Mexico. Anti-phospholipid antibody syndrome 
(APS) has been rarely described in LPh. We report a case of Lucio-Latapí leprosy 
with LPh observed in a patient from the province of El Oro in Ecuador, who 
presented clinical manifestations of long standing DLL (non-nodular infiltration 
of the skin, collapse of the nasal pyramid, madarosis, atrophy of the earlobes), 
of LPh (necrotic-haemorrhagic macules with irregular shapes) and of APS 
(necrosis of the right big and second toe). Histopathology showed perineural and 
periadnexal foamy macrophages with numerous bacilli (diagnostic of LL) in the 
subcutis, a mild lobular panniculitis with a large subcutaneous vessel 
infiltrated by macrophages in the wall (typical of LPh) and vessels of the 
superficial and mid dermis occluded by thrombi but without signs of vasculitis 
(typical of occlusive vasculopathy as in APS). Our observations suggest that 
some cases of LPh may be associated with APS. Anti-cardiolipin antibodies (aCL) 
and lupus anticoagulant (LA) should be tested in patients with LPh because this 
may have therapeutic implications.