Abstract
BackgroundNon-healing plantar ulcers are one of the significant causes of disability in leprosy patients. Plantar ulcers often take months or years to heal, affecting the patient’s quality of life. Presence of comorbid conditions in these patients can delay wound healing. The study aimed to evaluate the role of associated comorbid conditions as risk factors in ulcer healing.Methodology/Principal findingsA total of 66 leprosy patients with plantar ulcers registered at LEPRA Society-Blue Peter Public Health and Research Center (BPHRC), Hyderabad, India from June 2018 to June 2019 were studied. Comprehensive clinical assessment was done, including screening for comorbid conditions and treated as per the recommended guidelines. About two-thirds of the participants were aged 50 and above, of which more than half were illiterates, and 93.5% were living below the poverty line. Majority of ulcers were seen on the forefoot; with the head of meta-tarsal bone 27 (41.6%) as the commonest site, followed by calcaneum 23 (38.3%) and great toe 10 (16.6%). Mean ulcer depth was 0.61 (0.57) cm, the area was 5.24 (6.73) cm2 and ulcer volume was 4.72 (14.33) cm3. Ulcer dimensions were significantly associated with low body mass index, hypertension and smoking.Conclusions/SignificanceIdentifying the risk factors delaying wound healing and detailed assessment of ulcers are of profound importance to predict the outcome of plantar ulcers in leprosy patients. The study findings indicate the need for better policies by the leprosy control program for the comprehensive management of plantar ulcers.
Highlights
Leprosy, a chronic infectious disease caused by the Mycobacterium leprae, continues to be one of the public health challenges for countries like India, which accounts for more than half of the world’s new leprosy cases [1]
Plantar ulceration is a major cause of disability in leprosy patients
Understanding the factors associated with non-healing of plantar ulcers and identifying appropriate control measures could be one of the major interventions for preventing disability in leprosy patients
Summary
A chronic infectious disease caused by the Mycobacterium leprae, continues to be one of the public health challenges for countries like India, which accounts for more than half of the world’s new leprosy cases [1]. Dysfunction of peripheral nerves resulting in skin anaesthesia is one of the salient clinical manifestations of leprosy, which further leads to disabilities, including ulcers [2]. Plantar ulcers are one of the commonest complications of leprosy leading to Grade 2disability (G2D) and occur in about 10% to 20% of patients [3]. Non-healing plantar ulcers are one of the significant causes of disability in leprosy patients. The study aimed to evaluate the role of associated comorbid conditions as risk factors in ulcer healing
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