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Case Reports
. 2016 Oct;13(5):726-8.
doi: 10.1111/iwj.12359. Epub 2014 Sep 8.

Neuropathic ulcers in leprosy treated with intralesional platelet-rich plasma

Elena Conde-Montero  1 , Celia Horcajada-Reales  2 , Petunia Clavo  3 , Irene Delgado-Sillero  2 , Ricardo Suárez-Fernández  2
Affiliations
Case Reports

Neuropathic ulcers in leprosy treated with intralesional platelet-rich plasma

Elena Conde-Montero et al. Int Wound J. 2016 Oct.

Abstract

Neuropathic ulcers in leprosy represent a therapeutic challenge for clinicians. Chronic ulcers affect patient health, emotional state and quality of life, causing considerable morbidity and mortality in addition to contributing to significant health care costs. The pathogenesis is mainly related to the abnormally increased pressure in areas such as the sole of the foot, secondary to lack of sensation and deformities induced by peripheral sensory-motor neuropathy. Conventional treatment of these wounds can be slow due to their chronic inflammatory state and the senescence of local reparative cells. Platelet-rich plasma (PRP) may restore the healing process, leading to a reparative phase. We present two patients with four neuropathic leprosy ulcers that have responded satisfactory to PRP treatment. PRP therapy has been growing as a viable treatment alternative for chronic ulcers. However, stronger scientific evidence is required to support its potential benefit for use in chronic wounds.

Keywords: Leprosy; Neuropathic ulcer; Platelet-rich plasma.

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Figures

Figure 1
Figure 1
Clinical aspect of the three plantar ulcers in patient 1, before initiation of treatment with platelet‐rich plasma injections: (A) 1‐year duration ulcer, December 2012 and (B, C) 6‐month duration ulcers, October 2013.
Figure 2
Figure 2
Patient 1: (A) almost complete ulcer epithelialisation after 9 weekly sessions of platelet‐rich plasma injections and (B) complete reepithelialisation of the two more recent ulcers after 12 weekly sessions. Notice the maintained response of the first treated ulcer, at 1‐year follow‐up.
Figure 3
Figure 3
Deep ulcer on the lateral malleolus (patient 2): (A) clinical aspect pre‐treatment and (B) excellent response after 9 weekly sessions of platelet‐rich plasma injections.
See this image and copyright information in PMC

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