Epidemiology, etiology, and treatment of chronic leg ulcer: experience with sixty patients

Background: Chronic leg ulcer (CLU) is reported to have an impact on virtually all aspects of life. Treatment is expensive and has large economic burden on many countries' health services. This presentation is to determine the impact; etiology; and presentation of CLU as well as the procedures for processing in a Nigeria tertiary care facility. Methods: All patients with CLU seen that were prospectively managed in our hospital between 2004 and 2006 have been included in the study. The data were analyzed by SPSS version 11.0 of software. Results: Sixty consecutive patients seen over a period of 3 years (2004-2006) were prospectively studied. There were two peak period of age presentation 30-39 and 50-69 years. The male female ratio was 1:1. Most of the patients (93.3) had unilateral ulcers and it was as common on the right as on the left. Fifty percent of patients had medical disorders. The commonest cause of CLU was poorly managed traumatic wound. Conclusion: Most patients benefited from debridement with or without split thickness skin graft or flap

Bacteriological Pattern of Wound Swab Isolates in Patients with Chronic Leg Ulcer

Purpose: To determine the pattern of bacterial pathogens and their antibiotic sensitivity profile in patients with infected chronic leg ulceration. Methods: Sixty swab specimens obtained from chronic leg ulcer (CLU) patients were cultured aerobically and the antibiotic sensitivity pattern of the recovered organisms determined by the modified Kirby -Bauer disc-diffusion method. Results: 47 (78.3) of the ulcers were infected out of which 39 (83.0) were culture positive. Most of the culture positive ulcers were on the distal third of the leg. The isolated bacteria from the wounds were Pseudomonas aeruginosa (33); Staphylococcus aureus (24); Proteus spp (15); Klebsiella spp (13); Citrobacter spp (13) and Escherichia coli (2). None of the patient without clinical evidence of wound infection had bacterial positive wound swab culture. All isolates were sensitive to third generation cephalosporin and floroquinolones but majority were resistant to ampicillin. Conclusion: Pseudomonas aeruginosa; Staphyloco-ccus aureus. Proteus spp; Klebsiella spp; Citrobacter spp and Escherichia coli sensitive to third generation cephalosporin and floroquinolones have been recovered from 78of patients with chronic leg ulcers in a tertiary health facility in Nigeria

L'ulcere phagedenique (U.P) du membre inferieur; particularites etiologiques; evolutives et therapeutiques a Bamako (Mali)

L'ulcere phagedenique du membre inferieur parait etre une affection assez frequente au Mali. Ces 5 dernieres annees; sa frequence annuelle moyenne est estimee a 2;09 pour cent des consultants du Service de Dermatologie de l'Institut Marchoux. En milieu tropical il pose des problemes diagnostiques et therapeutiques particuliers. A propos de 50 cas; les auteurs decrivent les aspects cliniques; tentent d'identifier les etiologies et d'instituer des traitements symptomatiques et/ou specifiques. Parmi les etiologies rencontrees l'infection microbienne (abces et impetigo negliges) occupe le premier rang (26 cas/50); les plaies traumatiques negligees occupent le rang (12 cas/50); puis viennent la drepanocytose (6/50); l'insuffisance veineuse (5/50). Les soins locaux (detersion et antisepsie) ont une place preponderante dans le traitement. La complication evolutive la plus redoutable demeure la transformation epitheliomateuse (ulcere phagedenique cancerise = U.P.K.) observee 5 fois/50

Carcinome epidermoique compliquant un lupus etythemateux [sic] discoide : 3 observations

Les auteurs rapportent 3 cas de carcinome epidermoide compliquant un lupus erythemateux discoide observes a Dakar. Ils attirent l'attention sur le fait qu'il existe; a cote de l'ulcere phagedenique; un certain nombre de dermatoses precancereuses qu'il importe de connaitre et que les mesures correctes a apporter a cette pathologie entrent dans le cadre de la prophylaxie du cancer cutane auquel les populations africaines paient encore un lourd tribut

Control and management of Buruli ulcer disease

A total of 460 cases of Buruli ulcer disease in various stages of development have so far been identified from 11 of the 18 districts of Ashanti Region; Ghana. This paper describes experiences gained in the control and management of the disease and mentions some lessions for the control and management of other chronic communicable diseases in developing countries. It suggests that owing to the low socio-economic status of the people usually affected; services should be provided free of charge and near to where they live. The paper notes that the management and control of Buruli ulcer is difficult and frustrating and requires a team of dedicated health workers to sustain it

Mycobacterium ulcerans infection (Buruli ulcer) in Ga district of Greater Accra region

A study of 22 subjects affected by Mycobacterium ulcerans (Buruli ulcer) in the Ga District of Greater Accra Region of Ghana; bordering the rivers Densu and Nsaki; is presented. Of these subjects 68.2 per cent were less than 15 years of age with a male to femal ratio of 1.8:1 and 63.6 per cent were either pre-school or school children. 72.7 per cent of the subjects were first affected before the age of 10 years. The distribution of the skin lesions involved the exposed skin areas in 86.4 per cent of cases and contact cases were identified in 50 per cent of the subjects. A complication of squamous cell carcinoma was observed in one subject. The possible modes of transmission are discussed

Korle-Bu Paediatric surgical experience of Buruli ulcer

Buruli ulcer is a chronic skin ulcer caused by the organism Mycobacterium ulcerans. In the paediatric surgical practice at the Korle-Bu Teaching Hospital; 15 patients with confirmed Buruli ulcers aged from 3 to 10 years were seen and treated over the period 1989-1991. Diagnosis was by biopsy which was positive in all cases in which it was done. Surgery by wide excision was the mainstay of treatment. Skin grafting was done in 3 cases. Length of hospital stay was in excess of 2 months. There were no deaths in the group presented; however; residual deformity occurred in all cases. The experience of these cases is presented here with a review of the literature