Buruli Ulcer: The Neglected Tropical Disease Affecting Nigeria's Communities

A Disease That Destroys Skin and Bone

Buruli ulcer is a chronic, necrotising skin infection caused by Mycobacterium ulcerans, a relative of the bacteria causing tuberculosis and leprosy. Nigeria is among the highest-burden countries, particularly in communities along rivers and waterways in Edo, Ondo, Ogun, and Cross River states.

How It Develops

The disease starts as a painless nodule on the skin — often on the arms or legs. M. ulcerans produces mycolactone, a toxin that destroys tissue and suppresses the local immune response simultaneously, allowing the infection to spread undetected. Without treatment, the lesion breaks down into an ulcer with characteristic undermined edges, destroying skin, subcutaneous tissue, and even bone.

Treatment

The WHO recommends an 8-week course of rifampicin plus clarithromycin. Early-stage lesions can heal with antibiotics alone. Advanced cases require surgery and skin grafting, followed by intensive wound care and physiotherapy to prevent contractures.

Any painless skin lesion near a waterway community that doesn't heal within 4 weeks warrants medical evaluation for Buruli ulcer. FXMed can facilitate testing and referral, and supports nutritional recovery (zinc, vitamin A, protein) for wound healing after treatment.