Lésions du pied dans la lèpre

Abstract

Leprosy (or Hansen disease) is an endemic infectious disease due to Mycobacterium leprae bacillus. Clinical symptoms are contingent on response patterns of the immune system. Leprosy has a preference for attacking the skin and certain peripheral nerves. «Leprotic foot » is the result of lesions in the nervous system. Clinical symptoms are stereotypic in that they stem from a common cause. But different stages of evolution can affect the appearance and the seriousness of the disease. Hypoaesthesia in the sole of the foot leads to chronic foot ulcers. Palaralysis of leg and foot muscles can lead to unnatural foot positions which increase the risk of ulcers. Nervous acropathy, infections due to Mycobacterium leprae bacillus and ulcers infected by other bacteria, associate to break down bone and joint tissue. There development leads to diseaded induced mutilations. Deterioration can continue independently of recovery from the leprotic infection when nerve damage is irreversible. Disease induced mutilation due to leprosy concerns more than three millions people in the world (with half of this number afflicted with foot lesions) and constitutes a serious physical, psychological and social handicap. The treatment of the foot lesions in leprosy is specific : with the use of leprotic polychemotherapy of leprosy, non steroid anti-inflammatories and corticotherapy to combat the destruction of the peripheral nerves during the leprotic reactions; preventative : with wound treatment, self diagnosis, basic health education, custom made shoes and surgery for the correction of deformities and paralysis, and the decompression of nerves; curative : with medical and surgical treatment of bone infections, corrective surgery and amputations.