The surgical management of lesions of ulcerans infections due to Mycobacterium ulcerans, revisited

The recommended approach to the management of ulcerans disease lesions is a combined surgical/multidrug medical approach. Small lesions may resolve spontaneously, and for other early lesions cure may be effected either by medication or simple excision alone. A much simpler, less-aggressive surgical approach, combined with antibiotics to manage the larger lesions of ulcerans disease, is described. The method both reduces the extent of residual scarring and hastens healing. It is of particular value to doctors working in more isolated areas. This approach was recommended by several authors in the 1960s, but seems to have been forgotten.