Techniques for covering soft tissue defects resulting from plantar ulcers in leprosy: Part I - general considerations and summary of results

Recurrent plantar ulceration is a common and serious complication occuring consequent to impairment of the tibial nerve in leprosy patients. In spite of many therapies and long therapeutic course, it is extremely difficult to abolish this complication in many cases because of extensive skin and soft tissue cushion loss due to repeated infection. Since the early 70 we have been using microscopic surgical techniques to reconstruct the ulcerated area using eight types of the flaps. In this series of papers we review out experience. Post operatively, the flapes survived in all cases, the long term results have proved satisfactory, and recurrent ulceration occurred in only three patients

Diagnostic exploration of enlarged peripheral nerves in suspected cases of leprosy. An analysis of 55 cases

In 55 cases presenting with enlarged peripheral nerves without any skin lesions, a rice grain sized biopsy of the nerve lesion was taken for histopathological examination. As a result definitive diagnoses could be established: leprosy was diagnosed in 32 cases. In 23 cases the cause of nerve enlargement was not leprosy: post traumatic neuritis 9, cysts 5, hypertrophic neuritis 3, nonspecific 4, neurofibroma 1, and amyloidosis 1. In all of these cases there was a deficit of the nerve function and postoperatively there were no complications. The authors, as a result of this experience, believe that surgical exploration nad biopsy is a harmless diagnostic tool for establishing a definitive diagnosis o fleprosy in cases presenting with enlarged peripheral nerves without any skin lesions. In 23 out of 55 such cases the nerve enlargement was proved to be other causes than leprosy