Leprosy and the Foot

Involvement of the foot:
Neuropathy – sensory loss is initially patchy distribution (diabetic neuropathy is ‘stocking and glove’ distribution); more severe in lepromatous type  puts foot at risk for trauma; muscle wasting from motor nerve involvement  intrinsic muscle atrophy, clawing of toes, foot drop.
Early neuropathy – impairment of light touch, loss of temperature and pain sensation – proprioception and tendon reflexes are initially not affected; dorsal surfaces of feet affected before plantar surface
Plantar ulcers

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