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close this bookClinical Guidelines and Treatment Manual (Médecins Sans Frontières, 1993)
close this folderChapter 4 - Skin conditions
View the document(introductory text...)
View the documentDermatology
View the documentImpetigo and other purulent dermatoses
View the documentHerpes simplex, Herpes zoster
View the documentScabies
View the documentLeg ulcer
View the documentFungal infection
View the documentAnthrax
View the documentOther skin conditions
View the documentEndemic syphilis, Yaws & Pinta
View the documentLeprosy

Leg ulcer

Erosive lesion of the skin, usually occurring on the lower leg caused by:

- vascular (venous and/or arterial) insufficiency,

- bacterial or parasitic infection,

- underlying metabolic disorders.

Phadegenic ulcers have no apparent cause, they extend and become chronic.

Treatment (dispensary)

- Clean with chlorhexidine-cetrimide or chloramin solutions (dilution: see table 25).

- Excise necrotic edges.

- Daily dressing.

- Rest with leg elevated.

- Give oral antibiotics if local treatment fails:
penicillin V(PO):
Adult: 2.4 MIU/d divided in 3 doses x 5 days
Child: 100,000 IU/kg/d divided in 3 doses x 5 days
If no improvement, give:
erythromicin (PO): 50 mg/kg/d divided in 3 doses x 7 days

- Skin graft if ulcer is large. Only graft after local treatment has rendered it clean and flat with red granulation tissue in the base.

Note

- Think of Guinea worm in endemic zones.

- Give tetanus toxoid .