Foot piercing

Introduction Foot perforation is one of the symptoms of leprosy peripheral neuropathy. It is a chronic infectious disease caused by M. leprae. The skin and peripheral nerves are the main target tissues of M. leprae. In the Schwann cells that are lurking in macrophages and peripheral nerves, the evolution of the disease after onset or after the onset depends on the immune status of the body. The human body's response to M. leprae is mainly cellular immunity, although it can produce specific antibodies, but it does not work to inhibit and kill M. leprae.

Cause

Leprosy is mainly transmitted through body and liquid skin damage such as nasal and oral secretions, sweat tear milk, semen, and vaginal secretions. After invading the human body, the leprosy is first lurking in the Schwann cells of macrophages and peripheral nerves. Whether the pathogenesis after the infection or the evolution of the disease depends on the immune status of the body. The human body's response to M. leprae is mainly cellular immunity, although it can produce specific antibodies, but it does not work to inhibit and kill M. leprae.

an examination

1 skin lesions with or no numbness.

2 surrounding or cutaneous nerves are thick.

3 skin lesions were positive.

Laboratory inspection:

1, wind smear examination: mainly from the skin and mucous membrane scraping tissue fluid to take materials, if necessary, can be used for lymph node puncture.

2, blood test: including blood sugar, liver function, kidney function, erythrocyte sedimentary examination, rheumatism series, immunoglobulin electrophoresis and other autoimmune related serological examination, serum heavy metal (lead, mercury arsenic, antimony, etc.) concentration detection. It is important for differential diagnosis.

Differential diagnosis

Differential diagnosis of foot perforation:

1. Diabetic foot: According to the definition of the World Health Organization (WHO): Diabetic foot refers to the destruction of lower limb infection, ulcer formation and/or deep tissue caused by diabetic neuropathy and various degrees of peripheral vascular disease. Clinically, due to the long-term exposure to hyperglycemia in diabetic patients, lower extremity arteriosclerosis, thickening of blood vessel wall, and decreased elasticity, blood vessels are prone to thrombosis and accumulate into plaques, resulting in lower extremity vascular occlusion and branch nerve injury. Thereby causing lesions in the lower extremity. The "foot" is farthest from the heart, and the occlusion phenomenon is the most serious, causing edema, blackening, rot, necrosis and dislocation. At present, major hospitals generally take amputation, bypass or dry chest transplantation for diabetic foot patients.

2, foot gangrene: diabetic foot lesions refers to: diabetic patients due to vascular disease caused by insufficient blood supply, due to neuropathy caused by sensory loss and infection with foot changes. Patients who have amputated for diabetic foot disease are 5 to 10 times more likely than non-diabetics. In fact, similar pathological changes can occur in other parts of the body, except that the incidence of foot lesions is significantly higher than in other areas. The main manifestations of diabetic foot are lower extremity pain and skin ulcers. From light to heavy, it can be intermittent claudication, lower limb rest pain and foot gangrene. In the early stage of the disease, the physical examination can detect the lack of blood supply to the lower limbs. For example, when the lower limbs are raised, the skin of the feet is pale, and when the lower limbs sag, it is purple-red. The feet are cold, and the dorsal artery pulsation weakens and disappears.

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