Cutaneous myiasis of scalp in a young girl related to Musca domestica.

Cutaneous myiasis is a parasitic disease secondary to the presence of the larvae of certain insects, particularly diptera, in the skin of man or vertebrates [1]. Human myiasis is a rare clinical condition, but more frequently seen in tropical and subtropical areas. Hot humid climate with inadequate sanitary conditions favor the development of this condition. Dermatitis, psychiatric illnesses, leprosy, and diabetes are some contributory factors [2]. Treatment of myiasis, once diagnosed, is simple and rapid recovery is anticipated.

Quality of reporting and of methodology of studies on interventions for trophic ulcers in leprosy: a systematic review.

BACKGROUND: In the process of conducting a systematic review on interventions for skin lesions due to neuritis in leprosy, we assessed several primary papers with respect to the quality of reporting and methods used in the studies. Awareness of what constitutes weak points in previously conducted studies may be used to improve the planning, conducting and reporting of future clinical trials. AIMS: To assess the quality of reporting and of methodology in studies of interventions for skin lesions due to neuritis in leprosy. METHODS: Items of importance for preventing selection bias, detection bias, attrition bias and performance bias were among items assessed. The items for assessing methodological quality were used as a basis for making the checklist to assess the quality of reporting. RESULTS: Out of the 854 references that we inspected eight studies were included on the basis of the inclusion criteria. The interventions tested were dressings, topical agents and footwear and in all studies healing of ulcers was the main outcome measure. Reporting of both, methods and results suffered from underreporting and disorganization. The most under-reported items were concealment of allocation, blinding of patients and outcome assessors, intention to treat and validation of outcomes. CONCLUSION: There is an apparent need to improve the methodological quality as well as the quality of reporting of trials in leprosy ulcer treatment. The most important threat in existing studies is the threat of selection bias. For the reporting of future studies, journals could promote and encourage the use of the CONSORT statement checklist by expecting and requiring that authors adhere to it in their reporting.

Tratamiento de la larva migrans cutánea (erupción serpiginosa): comparación entre albendazol y el tratamiento tradicional / Treatment of larva migrans cutanea (creeping eruption): a comparison between albendazole and traditional therapy

Objetivo: La erupción serpiginosa (ES), que es característica de las regiones tropicales y subtropicales, se está observando cada vez con más frecuencia en Italia. La presencia en las playas de animales extraviados infectados por nematodos de la especie Ancylostoma favorece el contacto entre la piel humana y el suelo infestado por la larva. Materiales y métodos: Describimos nuestra experiencia con 56 pacientes (13 tratados con crioterapia, 1 con tiabendazol y crioterapia, 6 con tiabendazol, 2 con albendazol y crioterapia y 34 con albendazol). Resultados: Se consiguió una curación rápida y definitiva en los 56 pacientes. Por tanto, la eficacia terapéutica de los distintos métodos utilizados es equivalente. Conclusiones: Creemos que albendazol debería considerarse como primera línea de tratamiento. Se tolera muy bien y la aceptación de los pacientes es buena (AU)

Tepezcohuité: una alternativa en el tratamiento de las úlceras neurotróficas de la lepra. A propósito de un caso

Se utiliza el "Aceite de Tepezcohuité" en el tratamiento de úlceras tróficas de larga duración en el pie de una enferma diagnosticada de lepra lepromatosa curada. Destacando la ausencia de sobreinfecciones durante la cicatrización de las mismas. Se aconseja su uso como alternativa terapéutica en países donde es común y fácil su obtención.

Comparison of topical phenytoin with normal saline in the treatment of chronic trophic ulcers in leprosy.

BACKGROUND: Trophic ulceration, one of the most common complications of leprosy, is disabling, distressing, and demoralizing for the patient. METHODS: The wound healing effects of topical phenytoin powder were compared with those of normal saline in a controlled in-patient study of 100 patients with 110 trophic leprosy ulcers of varying chronicity, over a 4-week study period. Fifty patients were assigned to the topical phenytoin group and 50 to saline therapy group. Ten patients had two ulcers each, and, in these cases, one ulcer was treated with phenytoin and the other with saline. RESULTS: Over the 4-week treatment period healthy granulation tissue appeared earlier, and mean percentage of ulcer volume reduction was greater, in the phenytoin group (72.1 +/- 19.9% versus 55.5 +/- 21.6%) compared with the control group. CONCLUSIONS: This difference was statistically significant at the level of P < 0.001. Phenytoin appears to be a useful agent for the promotion of healing of trophic leprosy ulcers.

Description y evaluación del tratamiento mediante injertos laminares de piel en pacientes de lepra portadores de úlceras crónicas en un antiguo leprosario

Se trata de la evaluación de una técnica sencilla de injertos laminares para al curación de úlceras tróficas de extremidades inferiores, realizado en Saa Pablo (Perú), pequeña localidad de la selva amazónica peruana, antiguo leprosario, por los médicos cirujanos-generales en el Centro de Salud que esta localidad dispone par la Atención Primaria de Salud. A un total de 9 pacientes enfemos de Hansen, forma lepromatosa, portadores de úlceras en extremidades inferiores, 5 de ellos bilaterales, con un tiempo promedio de 17 años, se les practicaron injertos laminares para la duración de dichas úlceras. Tanto la preparación preoperatotia, como la técnica y los cuidados postoperatorios fueron muy sencillos, como corresponde al lugar donde trabajamos. Se obtuvieron buenos resultados aún a pesar de las recaídas en los siguientes a la cirugía.

Polambakkam splint for treatment of plantar ulcer in leprosy.

An open type of short leg splint is described and illustrated for the treatment of plantar ulcer in leprosy. Its fabrication, method of application, advantages and disadvantages are discussed as compared to the other methods of immobilisation. In our short experience we have found that with the use of this splint, ulcers heal in a period of about 6 weeks and in many cases even earlier than this period.

Heel ulcers in leprosy patients.

The incidence, causes, clinical presentation and management of ulcers of heel in the insensitive feet of leprosy patients are described. It is pointed out that heel ulcers usually arise as the result of injury and infection and are eminently preventable. Various surgical and non-surgical measures needed for preventing recurrence of the ulcer are also discussed.

The surgical management of leprosy

Leprosy is a disease which has traditionally been managed in isolation. There is no justification for the continuance of such a policy, and one of the results of the integration of leprosy in a general hospital service is that the general surgeon will sooner or later be confronted with aspects of leprosy which call for his services.