Multidisciplinary approach for diabetic and leprosy feet

Leprosy Mailing List, April 15th, 2008

Ref.: Multidisciplinary approach for diabetic and leprosy feet.
From: Faber W., Amsterdam, The Netherlands


Dear Salvatore,
Recently, there has been an interesting discussion on the LML about the management of ulcers on the feet of leprosy patients. It has not been clear, however, how big the burden of neuropathic foot care is in programmes or institutions where people afflicted by leprosy are treated? I would be interested to get comments on the following points.

It is of interest, with the new WHO policy of sustainable leprosy care in mind, to have an estimation of the prevalence and workload of these patients. And in this respect I think neuropathic foot ulcers are the most important. Also, ulcers are the entry point of infection leading to soft tissue infection and osteomyelitis. As ulcers on deformed feet, with the Charcot foot as the most extreme presentation, are more difficult to manage it is of interest to have information on deformity, and localisation of the ulcers.

For this purpose the Dutch Neuropathic Foot Society has developed a registration form, the so-called FINU form, which can be used for all kinds of neuropathic feet. And which is very useful to register the changes, including ulcers, of the feet, and is also of value in follow-up.
However, in the (near) future the “diabetic foot” will be a far bigger problem than the “leprosy foot”. And it is of interest to know to which extent the knowledge and skills of professionals involved in the care of leprosy feet are also used for the care of diabetic feet. And if they participate in a multidisciplinary approach for diabetic feet.

Best regards,

William