Patient of Dr

This is a woman, 30's from Arnhem Land... she has known leprosy.. and is on the medical recall list.... has been to numerous clinics.... but compliance is an issue. She dislikes wearing appropriate dressings / shoes and taking meds is an erratic process.
She was sent to Darwin and the overall condition improved... only to relapse on one side... after walking barefoot again... abscess, purulent coinfection ,leading to an osteomyelitis and need for surgical debridement of a few metatarsals.....

Her sister also had leprosy. Both in their 30's.

Another elderly women, also leprosy, unable to walk, no use hands..for many years... has just stumps of fingers,toes/feet. .. she recently died of mets Breast cancer... age 70's, peacefully, quietly refusing any meds for any condition...........

This is a great teaching case both from the point of view of the images and the difficulty in pining down some patients and treating them appropriately. The neuropathy of leprosy leads to traumatic ulcerations with secondary infections and sometimes loss of limbs. (Submitted By: Dr Ian McColl)