Trophic ulceration of the foot treated with intra-arterial hydergine.

Trophic ulceration of the foot is one of the commonest complications of leprosy, and one whose treatment presents many difficulties. The peripheral neural involvement causing loss of sensation, tactile and thermal, leads indirectly to ulceration especially of the feet due to (a) traumatization of the anesthetic area, usually over a bony prominence, and (b) an adjuvant deformity, e.g., a talipes varus, presenting an area to the sustained and continued pressure of weight-bearing. In these cases there is alteration of normal circulation to the extremity as a whole, the resulting avascularity being a contributory factor in the chronicity of the lesion.