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Introduction: Leprosy is a curable disease, treated by multidrug therapy. However, patients are often left with neuropathic damage leading to lifelong vulnerability to ulcers. Quantifying the value of interventions to improve ulcer healing is challenging as data on the health impact of plantar ulcers are scarce, especially in low- and middle-income countries. We aim to quantify the impact of plantar ulcers on patients' health-related quality of life (HRQoL) using methods which can inform decisions about the effectiveness and cost-effectiveness of alternative forms of management., Methods: Generic HRQoL data were collected using the EuroQol (EQ)-5D-3L questionnaire in a randomised control trial in Nepal, treating plantar ulcers with leukocyte and platelet-rich fibrin or usual care. The trial followed 130 patients resulting in 600 observations. EQ-5D data were converted into a single 'utility' score by weighting the instrument's different dimensions using the preferences of the Sri Lankan population. Utility data were analysed using general estimating equation regressions. The impact of an ulcer on HRQoL was estimated whilst controlling for clinical and demographic covariables., Results: Estimated mean utility (standard error) for the sample across all time points was 0.52 (0.02) for patients with an ulcer and 0.64 (0.01) with a healed ulcer. Controlling for clinical and demographic covariates, we estimate that the presence of an ulcer leads to a 0.12 (0.02) decrement in HRQoL compared with a healed ulcer., Discussion: Based on the levels of health they report and the values of the general public, patients with a history of leprosy are at risk of significant HRQoL burden from neuropathic plantar ulcers. Quantifying this health impact provides important evidence to assess the effectiveness and cost-effectiveness of leprosy ulcer interventions and ensures that interventions for leprosy ulcers can be appropriately considered for funding under Universal Health Coverage against other potential uses of the same money., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Gibbs et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Leprosy is a chronic infection caused by bacteria called Mycobacterium leprae . This is a prevalent disease in low-income countries, and it has not been completely eradicated. We present the case of a 29-year-old man with a previous diagnosis of Hansen's disease, who consulted for pain in the left elbow and wrist, associated with fever with preserved mobility and pain on palpation. Diagnosis of mononeuropathy of the ulnar nerve was made by MRI of the elbow and forearm. This entity corresponds to an infrequent complication of this infection with few cases reported in the literature. Our added value with this case is to show and explain the clinical imaging correlation, which is vital to understand the presentation of symptoms and to carry out a comprehensive and rapid approach to establish adequate and timely treatment., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Leukocyte- and platelet-rich fibrin (L-PRF), a by-product of centrifuged autologous whole blood, contains high concentrations of platelets, leukocytes, and fibrin (the latter spontaneously creating a strong 3-D network (a membrane)). L-PRF membranes possess several characteristics essential in wound healing, including a barrier function, an antibacterial and analgesic activity, and the release of growth factors enhancing tissue regeneration and neo-vasculogenesis. This review investigated the role of L-PRF in treating non-responding chronic wounds such as diabetic foot, venous leg ulcers, pressure ulcers, complex wounds, leprosy ulcers (Hansen's Disease), and other demanding wounds. Chronic wounds affect millions worldwide, negatively impacting their quality of life, productivity, and life expectancy while incurring high treatment costs for themselves and private and public health systems. L-PRF has demonstrated clear adjunctive advantages in treating chronic skin wounds, shortening the time to complete wound closure, and improving patient-reported outcome measures (including reducing pain and minimizing the need for analgesics). Also, in other demanding wounds, L-PRF facilitates healing. To help clinicians, this article also proposes recommendations for the use of L-PRF in the treatment of extra-oral wounds., (© 2024 The Author(s). Periodontology 2000 published by John Wiley & Sons Ltd.)

Hansen's disease is an infectious granulomatous disease with classical cutaneous and neurological profile and varied musculoskeletal manifestations. Poor awareness and low specificity of symptoms lead to a delay in the diagnosis of a treatable disease, culminating in worsening morbidity. A rare case series of Hansen's arthritis, showing complex, diverse, and rare combinations of musculoskeletal manifestations of acute lepra reaction over chronic arthritis, besides cutaneous and neurological manifestations, must be understood for early diagnosis and treatment to avoid debilitating complications., (© Journal of The Association of Physicians of India 2025.)

Background: The treatment of leprosy reactions (LRs) involves thalidomide, corticosteroids, and other immunomodulatory medications. This study evaluated the effect of these treatments on the association between periodontitis and LRs, as well as factors associated with LRs., Methods: This case-control study was conducted on 283 individuals followed at a leprosy outpatient clinic in Brazil. The case group was comprised of 158 individuals presenting type 1 or type 2 LRs, and the control group of 125 leprosy individuals without reactions. A complete oral examination was performed to diagnose periodontitis, the independent variable. Antireaction medication used was collected from medical records, and participants were classified according to the use of prednisone and/or thalidomide, time of use, or non-use of medication. Socioeconomic-demographic, clinical, and lifestyle covariables were collected by interview. Unconditional logistic regression analysis by subgroups evaluated the effect of antireaction medication on the association between periodontitis and LRs, estimating the odds ratio with a 95% confidence interval (OR; 95% CI)., Results: A relationship between periodontitis and LRs was observed only in the subgroup using the association prednisone and thalidomide: OR adjusted  = 0.32; 95% CI = 0.11-0.95. Conversely, more severe periodontal clinical parameters were observed in cases versus controls. Several socioeconomic, health conditions, and lifestyle factors were associated with the presence of LRs., Conclusions: Although periodontal disease indicators were worse among the cases, the findings showed a negative relationship between periodontitis and LRs in individuals receiving associated prednisone and thalidomide. These medications appear to influence the inflammatory cascade between diseases, modifying and masking the manifestations of periodontitis., (© 2024 American Academy of Periodontology.)

Purpose: This study aimed to report the incidence, characteristics, and prognosis of corneal perforation in patients with leprosy., Study Design: Retrospective observational study., Methods: Patients who presented with leprosy and visited a specialised ophthalmology hospital (Miyata Eye Hospital, Miyazaki, Japan) between 1980 and 2020 were included. Their medical charts were retrospectively reviewed, and the incidence of lagophthalmos and corneal perforation was examined. Additionally, the presentation, treatment, and prognosis of patients with corneal perforations were assessed., Results: In total, the records of 472 eyes of 236 patients (128 men and 108 women; mean age, 81.2 ± 7.5 years) diagnosed with leprosy were reviewed. Forty-one patients were diagnosed with lagophthalmos, and two of these patients (4.8%) showed signs of corneal perforation. Patients with lagophthalmos presented significantly more frequently with cicatricial contraction of eyelids (p < 0.001), superficial punctate keratopathy (p < 0.001), epithelial defect (p = 0.039), and corneal ulcer (p < 0.001) compared with patients without lagophthalmos. Patients with corneal perforation had uveitis more frequently compared with those without corneal perforation (p = 0.01)., Conclusion: Patients with leprosy frequently develop lagophthalmos. Patients with uveitis associated with leprosy are especially at risk of corneal perforation., Competing Interests: Declarations. Conflict of interest: T. Ono, None; T. Iwasaki, None; K. Takada, None; S. Tokuda, None; T. Sakisaka, None; Y. Mori, None; R. Nejima, None; M. Kakibuchi, None; T. Miyai, None; K. Miyata, None., (© 2024. Japanese Ophthalmological Society.)