Thomssen H
Hautarzt. 2002 May;53(5):334-7. doi: 10.1007/s001050100253.
Buruli ulcer is a chronic ulcerative skin disease caused by Mycobacterium ulcerans. It is the third most common mycobacterial disease in immunocompetent people and affects mainly children living in humid areas of the tropical rain forest. The mode of transmission is unknown. The microorganisms penetrate the skin via microinjuries. A few weeks after infection, a subcutaneous nodule develops, followed by necrosis of the subcutaneous fat and finally by a large dermal ulceration. Typical is the lack of an acute inflammatory response, likely due to an immunosuppressive toxin produced by M. ulcerans called mycolactone. The lesions mostly affect the limbs. Constitutional symptoms are normally absent. The only effective treatment consists of wide excision, often followed by skin grafts. Conservative measures are rarely successful. Buruli ulcer is characterized by low mortality and high morbidity. Early recognition and treatment are decisive for the complete cure and prevention of debilitating deformities.
布鲁里溃疡是由溃疡分枝杆菌引起的一种慢性溃疡性皮肤病。它是免疫功能正常人群中第三常见的分枝杆菌病，主要影响生活在热带雨林潮湿地区的儿童。传播方式尚不清楚。微生物通过微小伤口侵入皮肤。感染几周后，会形成一个皮下结节，随后皮下脂肪坏死，最终形成一个大的皮肤溃疡。典型的情况是缺乏急性炎症反应，这可能是由于溃疡分枝杆菌产生的一种名为分枝杆菌内酯的免疫抑制毒素所致。病变大多影响四肢。通常没有全身症状。唯一有效的治疗方法是广泛切除，术后常需植皮。保守治疗很少成功。布鲁里溃疡的特点是死亡率低、发病率高。早期识别和治疗对于彻底治愈和预防致残性畸形至关重要。
