Leprosy Mailing List – February 27, 2014
Ref.: (LML) Leprosy patient with foot ulcer
From: P Forgione, Naples and S. Noto, Bergamo, Italy
Dear Pieter
Thank you very much for the question from Robert S. Jerskey, LML February 4, 2014. He asked about the footwear used by the patient. Excuse me for the delay in this answer.
It was about the case of a leprosy patient from Bangladesh seen in Naples, Italy, suffering from borderline lepromatous - lepromatous (BL-LL) leprosy, recurrent erytehma nodosum leprosum (ENL) reaction and foot ulcer. The slit-skin smear examination reported: bacteriological index (BI) 4+, morphologic index (MI) 0.8% and globi.
The patient arrived in hospital with severe ENL reaction and an ulcer on the border of the right heel (see attached slides 2-4). The plantar weight-bearing surface of the sole is dry but with no ulcer. The ulcer healed in about 6 months (slide 5). The treatment was rest in bed and, when he was better he went around in the ward on cheap open sandals. When he was released from hospital no special footwear were provided. The ulcer relapsed and this time it was deeper and larger. It slowly closed again with rest during his further long admission to hospital; again no special shoes where used.
Best regards,
Salvatore
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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