Neuropathic ulcers in leprosy: clinical features, diagnosis and treatment

Serrano-Coll, Héctor; Cardona‐Castro, Nora

doi:10.12968/jowc.2022.31.sup6.s32

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…Neurological injury determines sensory and motor alterations that lead to the installation of varying degrees of physical disabilities, among them are plantar ulcers that due to the difficulty of healing, these lesions constitute a great challenge among health professionals who deal with this issue [2,[4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological clinical profile and closure of chronic plantar ulcers in patients with leprosy sequelae undergoing orthopedic surgery in a municipality in western Amazon

João

Peninni²,

Vasconcelos

et al. 2023

PLoS ONE

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Introduction Chronic plantar ulcers in leprosy are lesions resulting from motor and sensory alterations caused by Mycobacterium leprae. They are lesions refractory to conventional dressings and present high recurrence rates. Objective To evaluate the epidemiological clinical profile of patients with chronic plantar ulcers associated with bony prominences in the lesion bed and to evaluate the efficacy of orthopedic surgical treatment of these lesions. Methods This is a descriptive and analytical retrospective study with the evaluation of medical records of patients undergoing surgical treatment of chronic plantar ulcers from 2008 to 2018. The surgical technique applied consisted of corrective resection of bone prominences and the primary closure of the lesion with bipediculated local flap. Results 234 patients were submitted to surgery, 55.1% male with an average age of 69.5 years old. Of these, 82.9% were illiterate; and 88.5% with open lesions over 10 years. After surgical treatment, total wound healing occurred in an average time of 12 weeks. The variables that contributed to shorter healing time were: Patients’ lower age group; regular use of orthopedic shoes and insoles and dressings performed by nurse aides in health units before surgery. Obesity was the factor that correlated with the delay of healing time. Conclusion A higher incidence was observed in males and male and female illiterate patients. The regular use of shoes and insoles and dressings performed by nurse aides in health units contributed to shorter postoperative healing time. Orthopedic surgical treatment with corrective resection of bony prominences proved to be an efficient therapeutic method for the closure of chronic plantar ulcers. It is a reproducible method, justifying the importance of the orthopedic surgeon in the context of the multidisciplinary team to cope with these complex lesions.

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Section: Introductionmentioning

confidence: 99%

Epidemiological clinical profile and closure of chronic plantar ulcers in patients with leprosy sequelae undergoing orthopedic surgery in a municipality in western Amazon

João

Peninni²,

Vasconcelos

et al. 2023

PLoS ONE

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“…Unfortunately, the effect of these treatments is often unsatisfactory. 17,18 In this study, 16S rDNA sequencing and metabolomics were used to analyze 28 cured participants with leprosyinduced ulcers of different types who had normal body mass index (BMI) and were distributed in all age and sex groups, with the surrounding normal skin tissues of these participants as controls for omics association analysis. In this way, this study investigated the pathological mechanisms of lower-limb ulcers in participants with leprosy sequelae to provide promising diagnostic targets and therapeutic strategies.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Lower-Limb Ulcers in Participants with Leprosy Sequelae Using Metabolomics and 16S Ribosomal DNA Sequencing

Wang,

Liang

et al. 2023

CCID

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Purpose This study investigated microbiome and metabolome differences between ulcerated tissues and normal skin from the lower limbs of participants with leprosy. Patients and Methods Ulcerated tissues and surrounding normal skin were collected from the lower limbs of 28 participants with leprosy who had been cured. The 16S ribosomal DNA sequencing analysis of the samples was conducted with the Illumina NovaSeq platform to analyze the community structure and diversity of microorganisms on the skin surface, followed by non-targeted metabolomic analysis with LC-MS technology. Next, differential metabolites were statistically screened, followed by metabolic pathway analysis. The Spearman method was used to analyze the correlation between differential microbiota and differential metabolites. Results Compared to normal skin, ulcerated tissues showed a decrease in microbial α diversity (species richness, homogeneity, and sequencing depth), without significant differences (observed species, Chao1, Shannon, Simpson, and Pielou’s evenness index; P > 0.05). Conversely, Jaccard distance demonstrated that sample β-diversity exhibited a certain degree of clustering ( P < 0.05), with significant differences between the two groups. The results of LEfSe analysis revealed that compared to the normal skin, the ulcerated tissues had significantly decreased microbial abundance of Flavobacteriaceae, Flavobacteriales, Lachnospiraceae, Lachnospirales, Enterobacterales, Acinetobacter , and Moraxellaceae , which might be associated with the ulcerative state. The Spearman correlation analysis suggested a strong correlation between skin metabolome and skin microbiome. Conclusion For participants with leprosy sequelae, skin microecology and metabolites are disturbed and species diversity and homogeneity are reduced in lower-limb ulcers, and the types of skin metabolites are dependent on the microbiota.

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Temporal trends and space–time distribution of leprosy relapse in Brazil from 2001 to 2021

Boigny,

de Sousa Cavalcante,

Florencio

et al. 2024

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background To analyse the temporal trends and spatiotemporal distribution of leprosy relapse in Brazil from 2001 to 2021. Methods An ecological study with a temporal trend approach and space–time analysis of leprosy relapse in Brazil was carried out with data from the Notifiable Diseases Information System. Results A total of 31 334 patients who experienced leprosy relapse were identified. The number of recurrent cases tended to increase throughout the study period, and this increase was significant among females and in almost all age groups, except for those <15, 50–59 and ≥70 y. Several clusters of high- and low-risk patients were identified across all regions with a heterogeneous distribution. Conclusions The burden of relapse showed an increasing trend in some groups and was distributed in all regions.

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Neuropathic ulcers in leprosy: clinical features, diagnosis and treatment

Cited by 3 publications

References 36 publications

Epidemiological clinical profile and closure of chronic plantar ulcers in patients with leprosy sequelae undergoing orthopedic surgery in a municipality in western Amazon

Epidemiological clinical profile and closure of chronic plantar ulcers in patients with leprosy sequelae undergoing orthopedic surgery in a municipality in western Amazon

Analysis of Lower-Limb Ulcers in Participants with Leprosy Sequelae Using Metabolomics and 16S Ribosomal DNA Sequencing

Temporal trends and space–time distribution of leprosy relapse in Brazil from 2001 to 2021

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