WITHDRAWN: Interventions for skin changes caused by nerve damage in leprosy

Area of Science:

• Dermatology
• Infectious Diseases
• Podiatry

Background:

• Leprosy affects over three million people globally, causing sensory nerve damage.
• Neuropathic ulceration, especially on the feet, is a primary complication of leprosy.
• Secondary skin and limb damage requires effective prevention and treatment strategies.

Purpose of the Study:

• To evaluate interventions for preventing and healing secondary skin and limb damage in leprosy patients.
• To assess the effectiveness of self-care, dressings, and footwear.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) involving individuals with leprosy and peripheral nerve damage.
• Searched multiple databases including Cochrane, MEDLINE, EMBASE, CINAHL, and LILACS.
• Two authors assessed trial quality and extracted data.

Main Results:

• Eight trials with 557 participants were included; trial quality was generally poor.
• Topical ketanserin showed better wound healing than clioquinol cream or zinc paste (RR 6.00).
• Topical phenytoin demonstrated statistically significant effects in ulcer healing compared to saline dressing (SMD -2.34 and -0.79).
• Footwear interventions (canvas shoes, double rocker shoes) showed limited comparative benefits.

Conclusions:

• Topical phenytoin and ketanserin may be effective for leprosy-related ulcer healing.
• Evidence for other dressings and footwear is equivocal.
• A significant lack of high-quality research necessitates new trials adhering to current RCT standards.