Interventions for skin changes caused by nerve damage in leprosy

In leprosy ulcer healing, topical ketanserin might possibly be more effective than clioquinol cream or zinc paste and topical phenytoin might possibly be more effective than saline dressing, but the evidence is insufficient.

A Cochrane review included 8 studies with a total of 557 subjects. One trial indicated that topical ketanserin had a better effect on wound healing than clioquinol cream or zinc paste, RR was 6.00 (95% CI 1.45 to 24.75). Two studies that compared topical phenytoin to saline dressing found statistically significant effects in favour of phenytoin for healing of ulcer (SMD -2.34; 95% CI -3.30 to -1.39; and SMD -0.79; 95% CI -1.20 to 0.39). Three studies that compared zinc tape to more traditional dressings found some benefit, but none of these showed a statistically significant effect. Canvas shoes were not much better than PVC-boots, and double rocker shoes did not promote healing much more than below-knee plasters.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes) and study quality (several issues).

Ədəbiyyat

1. Reinar LM, Forsetlund L, Bjørndal A, Lockwood D. Interventions for skin changes caused by nerve damage in leprosy. Cochrane Database Syst Rev. 2008;(3):CD004833.