Tropical ulcers are necrotic painful lesions that result from a mixed bacterial infection. They are common in hot humid tropical or subtropical areas, where they occur on the lower legs or feet of children and young adults. Typically, they have a raised, slightly undermined border and a yellowish necrotic base. Tropical ulcers may heal spontaneously but in some instances extension may occur, resulting in deep lesions which penetrate into muscles, tendons and bone. Untreated, tropical ulcers can result in much scar tissue and disability.

Management

Daily dressing with 0.65% aluminium diacetate, 0.01% potassium permanganate or 0.005% silver nitrate solution is often sufficient to arrest progression of localized ulcers and promote healing. The lesions should also be treated with procaine benzylpenicillin, 600000 IU daily (25 000-50000 IU/kg for children under 12 years) for 2-4 weeks.