oa Central African Journal of Medicine - Mycobacterial skin ulcers -Clinical experiences

Volume 11, Issue 5
  • ISSN : 0008-9176



In the past two and a half years 28 cases of mycobacterial skin ulcers have been seen and treated in our hospital. It is felt that this entity begins as a phlegmon in the subcutaneous tissues with peripheral spread causing pressure necrosis of overlying skin, thus forming an ulcer. This ulcer is associated with wide undermining of skin edges and induration of the surrounding skin. Diagnosis has been made by history and clinical appearance, taking of a smear from underneath ulcer edges and staining for acid-fast bacilli, and biopsy of the ulcer edges, especially the gelatinous material. Bacteriological cultures can be done if proper laboratory facilities are available. The only effective treatment in our hands has been wide excision of the involved tissue followed later by split-thickness skin grafts. Much remains to be done to determine the epidemiology of this disease. Some workers feel that Mycobacterium ulcerans is a soil saprophyte; others feel that certain fish may act as a reservoir of infection.

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