Last Updated: 2021-10-15
Desert ulcer, tropical ulcer, tropical ulcer, tropical phagedena.
Special form of Ecthymata.
A disease that occurs particularly in the tropics.
- Penetration of the pathogens by small skin injuries.
- Pathogens: streptococci and staphylococci, gram-negative bacteria or plaut-vincent organisms. Often secondary colonisation with fusospirillosis.
Predisposing factors: malnutrition, especially with protein deficiency.
- Skin lesions, often after minor injuries, result in blood-filled bullae. After incision a necrotic ground is visible, which often reaches the subcutaneous tissue, sometimes even deeper down to the fascia or the muscles and periosteum.
In addition, extremely pronounced scarring with dermatogenic contractures is described in the healing process, which requires amputations.
- Medical history
Especially distal lower legs.
- Early antibiotic therapy is essential.
Recurrences are possible.
PenicillinG i.v. 4 million IU 6x daily.
PenicillinV p.o. 3x daily 0.4-1.2 million IU (adults), 0.2-0.6 million IU 1x daily (infants) for about 10 days.
Erythromycin p.o. 500 mg 3x daily, maximum dose: 4 g/d (adults), 40-100 mg/kg
Gentamicin intravenously 5 mg/kg bw
Ciprofloxacin p.o 500 mg 2x daily.
- Moist, antiseptic envelopes e.g.: Lavasept®-Lsg. or Octenisept®-Lsg.
Surgical intervention, if necessary.
- Adriaans B, Hay R, Drasar B , Robinson D. The infectious aetiology of tropical ulcer—a study of the role of anaerobic bacteria. Br J Dermatol 1987;116:31-7.
- MacDonald P. Tropical ulcers: a condition still hidden from the Western world. Journal of Wound Care 2003;12:85-90.
- Meyers WM , Portaels F. Mycobacterium ulcerans Infection (Buruli Ulcer). Tropical Infectious Diseases: Elsevier BV; 2006. p. 428-35.
- Na. Protozoa in a Case of Tropical Ulcer (Delhi Sore). The American Journal of the Medical Sciences 1904;127:938.