BACKGROUND: Lucio's phenomenon is a rare manifestation of untreated leprosy 
which is seen almost exclusively in regions surrounding the Gulf of Mexico. Its 
occurrence elsewhere though documented is considered uncommon. We present a case 
of Lucio's phenomenon in a previously undiagnosed leprosy patient who presented 
to us with its classical skin manifestations.
CASE PRESENTATION: A 64 year old South Asian (Sri Lankan) male with a history of 
chronic obstructive airway disease presented to us with fever and cough. He had 
a generalized smooth and shiny skin with ulcerating skin lesions afflicting the 
digits of the fingers. The lesions progressed to involve the extremities of the 
body and healed with crusting. Based on the clinical and investigational 
findings Tuberculosis and common vasculitic conditions were suspected and 
excluded. The unusual skin manifestations prompted a biopsy, and wade fite 
stained revealed Mycobacterium bacilli. In context of the clinical picture and 
histological findings, Lucio's phenomenon was suspected. A clinical diagnosis of 
Lucio's phenomenon occurring in the backdrop of lepromatous leprosy was made.
CONCLUSION: Though leprosy is still a prevalent disease, it has manifestations 
that are not easily recognized or fully appreciated. Regional patterns of 
atypical manifestations should not limit better understanding of rarer 
manifestations as it will aid in clinching an early diagnosis and instituting 
prompt treatment, thereby reducing morbidity and mortality.