Does skin surface temperature variation account for Buruli ulcer lesion distribution?

Area of Science:

• Infectious Diseases
• Dermatology
• Environmental Health

Background:

• Buruli ulcer is a necrotizing skin infection caused by Mycobacterium ulcerans.
• Lesion distribution is hypothesized to relate to environmental exposure but is not random.
• Mycobacterium ulcerans has optimal growth in vitro at 30-33°C, inhibited by higher temperatures.

Purpose of the Study:

• To investigate if variations in human skin surface temperature correlate with Buruli ulcer lesion distribution.
• To determine the extent to which skin temperature explains lesion patterns.

Main Methods:

• Observational study using a thermal camera to measure skin surface temperature on 18 healthy volunteers.
• Comparison of skin temperatures at high, middle, and low Buruli ulcer incidence locations.
• Analysis of temperature differences based on age and sex.

Main Results:

• A significant inverse relationship was found: high incidence areas were cooler, and low incidence areas were warmer (p<0.0001).
• Skin temperature explained 22.0% of lesion distribution variance in anterior locations, but only 0.6% in posterior locations.
• Men exhibited warmer upper and lower limbs compared to women (p<0.0001).

Conclusions:

• An inverse association exists between skin temperature and Buruli ulcer lesion distribution, though it is a weak correlation.
• Additional unidentified factors are crucial for explaining the majority of Buruli ulcer lesion distribution variance.