Despite his extensive ulcerations, he is actually quite well and did not seem to be of much pain when dressing / undressing his wound.

There were extensive demarcated, some jagged ulceration and has multiple necrotic scabs over his bilateral feet and leg.
A closed up view showed degloving like ulcers with loss of toe nails over the digits.

Apart from his obvious problem of ulcers, he has a glistening face with purpuric patch with necrotic scab over his pinna and nasal area. He also has loss of eyebrow with pinna and the eyebrow region appearing infiltrated.

Skin biopsy showed leukocytoclastic vasculitis with numerous AFBs invading blood vessels.

Slit Skin smear is also positive.

View this case report

Related Links:
Dermnet on Leprosy
Leprosy Pathology

Lucio phenomenon is a rarer type of immune reaction occuring when lepromatous leprosy is treated. The commoner presentation of the type 2 reaction is erythema nodosum leprosum with erythema nodosum like lesions scattered over a larger body area than the shins but Lucio's is a vasculitis of small vessels giving the lesions we see here today.
The Type 1 reaction in treated leprosy is enlargement of nerve or skin lesions with an increase in Type 4 immune hypersensitivity . (Submitted By: Dr Ian McColl)