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Buruli ulcer
Rie R Yotsu1,2, Rachel E Simmonds3, Dziedzom K de Souza4
1Department of Tropical Medicine and Infectious Disease, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA. ryotsu@tulane.edu.
Nature Reviews. Disease Primers
|December 18, 2025
Summary
Buruli ulcer, a neglected tropical disease caused by Mycobacterium ulcerans, is characterized by necrotizing skin lesions. Understanding mycolactone
Area of Science:
- Infectious Diseases
- Dermatology
- Tropical Medicine
Background:
- Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans.
- Mycolactone, an exotoxin from M. ulcerans, inhibits the Sec61 translocon, leading to tissue destruction and immune suppression.
- Transmission mechanisms remain largely unknown, hindering prevention efforts.
Purpose of the Study:
- To review current understanding of Buruli ulcer pathogenesis, diagnosis, and treatment.
- To highlight challenges in diagnosis and treatment, particularly in resource-limited settings.
- To outline future research directions for Buruli ulcer control.
Main Methods:
- Literature review of Buruli ulcer research.
- Analysis of diagnostic methods, including PCR.
- Evaluation of current treatment regimens and adjunctive care.
Main Results:
- Mycolactone's role in pathogenesis is a key advance.
- PCR is the diagnostic gold standard, but accessibility is limited.
- Effective treatment involves antibiotics (rifampicin/clarithromycin) and comprehensive wound care.
Conclusions:
- Further research is needed on transmission, rapid diagnostics, and optimized treatments.
- Integrated healthcare worker training and disease control are crucial.
- Early diagnosis and treatment are vital to prevent disability and improve quality of life.
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