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J Dermatol. 2015 Nov;42(11):1033-41. doi: 10.1111/1346-8138.13049. Epub 2015 Sep 01.

Revisiting Buruli ulcer.

The Journal of dermatology

Rie R Yotsu, Chiaki Murase, Mariko Sugawara, Koichi Suzuki, Kazue Nakanaga, Norihisa Ishii, Kingsley Asiedu

Affiliations

  1. Department of Dermatology, National Suruga Sanatorium, Shizuoka, Japan.
  2. Department of Dermatology, National Center for Global Health and Medicine, Tokyo, Japan.
  3. Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  4. West Yokohama Sugawara Dermatology Clinic, Yokohama, Japan.
  5. Department of Clinical Laboratory Science, Faculty of Medical Technology, Teikyo University, Tokyo, Japan.
  6. Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
  7. Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.

PMID: 26332541 DOI: 10.1111/1346-8138.13049

Abstract

Buruli ulcer (BU), or Mycobacterium ulcerans infection, is a new emerging infectious disease which has been reported in over 33 countries worldwide. It has been noted not only in tropical areas, such as West Africa where it is most endemic, but also in moderate non-tropical climate areas, including Australia and Japan. Clinical presentation starts with a papule, nodule, plaque or edematous form which eventually leads to extensive skin ulceration. It can affect all age groups, but especially children aged between 5 and 15 years in West Africa. Multiple-antibiotic treatment has proven effective, and with surgical intervention at times of severity, it is curable. However, if diagnosis and treatment is delayed, those affected may be left with life-long disabilities. The disease is not yet fully understood, including its route of transmission and pathogenesis. However, due to recent research, several important features of the disease are now being elucidated. Notably, there may be undiagnosed cases in other parts of the world where BU has not yet been reported. Japan exemplifies the finding that awareness among dermatologists plays a key role in BU case detection. So, what about in other countries where a case of BU has never been diagnosed and there is no awareness of the disease among the population or, more importantly, among health professionals? This article will revisit BU, reviewing clinical features as well as the most recent epidemiological and scientific findings of the disease, to raise awareness of BU among dermatologists worldwide.

© 2015 Japanese Dermatological Association.

Keywords: Buruli ulcer; Mycobacterium ulcerans; mycolactone; neglected tropical diseases; non-tuberculous mycobacteria

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