Neuropathic ulcers: a focused review

2020 ◽  
Author(s):  
Brittany Urso ◽  
Mondana Ghias ◽  
Anan John ◽  
Amor Khachemoune
Keyword(s):  
Neuropathic Ulcers

Unusual non-trophic ulcerations in leprosy: A case series of 17 patients

2021 ◽  
pp. 004947552199849
Author(s):  
Prakriti Shukla ◽  
Kiran Preet Malhotra ◽  
Parul Verma ◽  
Swastika Suvirya ◽  
Abir Saraswat ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Case Series ◽  
Lepromatous Leprosy ◽  
Sweet Syndrome ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients ◽  
Atypical Presentations ◽  
Neuropathic Ulcers

Non-neuropathic ulcers in leprosy patients are infrequently seen, and atypical presentations are prone to misdiagnosis. We evaluated diagnosed cases of leprosy between January 2017 and January 2020 for the presence of cutaneous ulceration, Ridley–Jopling subtype of leprosy, reactions and histologic features of these ulcerations. Treatment was given as WHO recommended multi-bacillary multi-drug therapy. We found 17/386 leprosy patients with non-neuropathic ulcers. We describe three causes – spontaneous cutaneous ulceration in lepromatous leprosy (one nodular and one diffuse), lepra reactions (five patients with type 1; nine with type 2, further categorised into ulcerated Sweet syndrome-like who also had pseudoepitheliomatous hyperplasia, pustulo-necrotic and necrotic erythema nodosum leprosum) and Lucio phenomenon (one patient). Our series draws attention towards the different faces of non-neuropathic ulcers in leprosy, including some atypical and novel presentations.

1997 William J. Stickel Bronze Award. Comparison of strategies for reducing pressure at the site of neuropathic ulcers

1997 ◽  
Vol 87 (10) ◽  
pp. 466-472 ◽  
Author(s):  
JG Fleischli ◽  
LA Lavery ◽  
SA Vela ◽  
H Ashry ◽  
DC Lavery
Keyword(s):  
Diabetes Mellitus ◽  
Measurement System ◽  
Pressure Measurement ◽  
Scientific Data ◽  
Consistent Pattern ◽  
Great Toe ◽  
The Third ◽  
System Data ◽  
Pressure Measurement System ◽  
Neuropathic Ulcers

Few scientific data are available on the effectiveness of commonly used modalities for reducing pressure at the site of neuropathic ulcers in persons with diabetes mellitus. The authors' aim was to compare the effectiveness of total contact casts, half-shoes, rigid-soled postoperative shoes, accommodative dressings made of felt and polyethylene foam, and removable walking casts in reducing peak plantar foot pressures at the site of neuropathic ulcerations in diabetics. Using an in-shoe pressure-measurement system, data from 32 midgait steps were collected for each treatment. There was a consistent pattern in the devices' effectiveness in reducing foot pressures at ulcer sites under the great toe and ball of the foot. Removable walking casts were as effective as or more effective than total contact casts. Half-shoes were consistently the third most effective modality, followed by accommodative dressings and rigid-soled postoperative shoes.

A Novel Method to Offload Neuropathic Ulcers of the Distal Phalanges in the Presence of First Ray Metatarsal Hypermobility

2021 ◽  
Vol 48 (3) ◽  
pp. 253-255
Author(s):  
Deborah Christensen ◽  
Jane Coviello ◽  
Sally Munn ◽  
Birgit Petersen ◽  
Elizabeth Whitaker
Keyword(s):  
First Ray ◽  
Novel Method ◽  
Neuropathic Ulcers

Neuropathic ulcers of the foot

1985 ◽  
Vol 67-B (3) ◽  
pp. 438-442 ◽  
Author(s):  
AI Lang-Stevenson ◽  
WJ Sharrard ◽  
RP Betts ◽  
T Duckworth
Keyword(s):  
Neuropathic Ulcers

Expression of tissue inhibitor of metalloprotease 3 is reduced in ischemic but not neuropathic ulcers from patients with type 2 diabetes mellitus

2013 ◽  
Vol 50 (6) ◽  
pp. 907-910 ◽  
Author(s):  
R. Menghini ◽  
L. Uccioli ◽  
E. Vainieri ◽  
C. Pecchioli ◽  
V. Casagrande ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tissue Inhibitor ◽  
Neuropathic Ulcers

Leg ulcer

2015 ◽  
Author(s):  
Hugo Farne ◽  
Edward Norris-Cervetto ◽  
James Warbrick-Smith
Keyword(s):  
Diabetes Mellitus ◽  
Time Course ◽  
Pressure Ulcers ◽  
Leg Ulcer ◽  
The Other ◽  
Venous Stasis ◽  
Leg Ulcers ◽  
Venous Ulcers ◽  
Patients With Diabetes ◽  
Neuropathic Ulcers

Venous ulcers account for by far the majority (about 70%), with mixed arterial/venous (about 10%) and arterial (about 10%) most of the remainder. Pressure ulcers have become increasingly common because of the increase in elderly, frail, and relatively immobile patients. The other causes are relatively rare with the exception of neuropathic ulcers in patients with diabetes mellitus. Note that many leg ulcers may have a multifactorial aetiology, i.e. they may involve more than one of the pathologies listed in Figure 29.1. The first thing is to ask about the ulcer. You should consider: • Is the ulcer painful? ■ Venous ulcers are caused by venous stasis in the leg and are thus less painful when elevated and drained of blood. However, only about 30% of venous ulcers are painful. ■ Arterial (atherosclerotic) ulcers are caused by ischaemia to the leg and are thus more painful when elevated and drained of blood. Patients often say the ulcers are painful enough to wake them up at night and that they obtain relief by lowering their leg over the side of the bed. ■ Neuropathic ulcers are caused by loss of sensation (which predisposes to constant trauma) and are thus not painful. ■ Pressure ulcers are caused by, as the name suggests, prolonged pressure on the affected site. They tend to be exquisitely tender but not necessarily painful if no pressure is being applied. • How long has the ulcer been there? ■ Venous ulcers are less painful and can therefore present late. They often have a long and recurring history. ■ Arterial ulcers tend to present relatively early because of pain. They often occur secondary to trivial trauma. ■ Neuropathic ulcers are associated with a loss of sensation and thus often present late. ■ Pressure ulcers can develop surprisingly rapidly (e.g. days in immobile patients if they are not turned regularly during their admission, even hours in patients who suffer a long lie following a fall), but can have a more indolent course depending on how much pressure is put on for how long. Thus the time course is not especially helpful. ■ A long history should arouse suspicion of a Marjolin ulcer, which only occurs in long-standing ulcers.

Neuropathic Ulcers

BMJ ◽  
1964 ◽  
Vol 1 (5394) ◽  
pp. 1384-1384
Author(s):  
E. W. Price
Keyword(s):  
Neuropathic Ulcers

Decompression with the Aid of Insoles in the Treatment of Diabetic Neuropathic Ulcers

1976 ◽  
Vol 47 (4) ◽  
pp. 463-468 ◽  
Author(s):  
P. Holstein ◽  
K. Larsen ◽  
P. Sager
Keyword(s):  
Neuropathic Ulcers

Therapeutic Footwear for Neuropathic Ulcers

1995 ◽  
Vol 16 (10) ◽  
pp. 663-666 ◽  
Author(s):  
Earl R. Slavens ◽  
Margie Linda Slavens
Keyword(s):  
Current Literature ◽  
Healing Process ◽  
Primary Treatment ◽  
Foot Ulcers ◽  
Ongoing Treatment ◽  
Therapeutic Footwear ◽  
Neuropathic Ulcers

Current literature on the treatment of patients with neuropathic ulcers generally does not fully consider pedorthic treatment. To evaluate pedorthic treatment of patients with neuropathic ulcers, an ongoing treatment and tracking program was developed. This program consisted of regularly scheduled visits, footwear inspections, and orthosis replacement, repair, or adjustment. Our intent is not to suggest that therapeutic footwear be used as a primary treatment to close foot ulcers, but to highlight the place of education, proper shoes, and orthosis in the healing process.

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