The clinical and epidemiologic features of tropical ulcer (tropical phagedenic ulcer)

A comparative survey of patients with tropical ulcer has been carried out in Zambia, Gambia, Southern India and Papua New Guinea. The clinical features, socioeconomic background and nutritional correlates have been compared in 170 patients. In 96% of cases the condition occurred on the foot or lower leg. In only 10 instances did the ulcer last for over six months. There was one patient with a squamous cell carcinoma arising in situ from the ulcer margin. No significant differences in clinical features were seen in the countries surveyed. In all areas apart from southern India most cases were seen in the rural population and in children or teenagers. There was no correlation between the development of an ulcer and nutritional status found in this survey. Evidence is presented that there is an association between tropical ulcer and exposure to mud or slow moving fresh water.