TY - JOUR KW - chronic ulcers KW - Non healing ulcer KW - Leprosy KW - Topical insulin KW - Trophic ulcer AU - Ratnaparkhi A AU - Fale P AU - Rahangdale V AU - Unni M AB - Leprosy, caused by Mycobacterium leprae, frequently leads to neuropathic trophic ulcers and ulcerative lesions associated with type II lepra reactions. These ulcers are difficult to treat due to sensory loss, repeated trauma, and poor vascularity, often responding inadequately to conventional therapies. Topical insulin has recently gained attention for its potential to enhance local wound healing by stimulating angiogenesis, collagen deposition, and re-epithelialization without systemic adverse effects. This case series included five male patients with Hansen’s disease who presented with chronic trophic ulcers or ulcerative lesions of lepra reaction. A solution of 0.1 ml Actrapid insulin diluted with 0.9 ml normal saline was irrigated directly to the ulcer surface twice daily and covered with sterile gauze for five minutes. The intervention was continued for four to six weeks. Ulcer size, depth, tissue quality, and granulation were assessed clinically and documented photographically at baseline and follow-up. All patients showed significant improvement within two weeks, with marked reduction in ulcer dimensions and healthy granulation tissue formation. Complete epithelization was achieved in four to six weeks. No local or systemic adverse effects were observed, and compliance was excellent. Topical insulin is a safe, economical, and effective therapeutic option for leprosy-associated ulcers, meriting further evaluation in larger controlled studies. BT - Nepal Journal of Dermatology, Venereology & Leprology DA - 05/2026 DO - 10.3126/njdvl.v24i1.84140 IS - 1 LA - ENG M3 - Article N2 - Leprosy, caused by Mycobacterium leprae, frequently leads to neuropathic trophic ulcers and ulcerative lesions associated with type II lepra reactions. These ulcers are difficult to treat due to sensory loss, repeated trauma, and poor vascularity, often responding inadequately to conventional therapies. Topical insulin has recently gained attention for its potential to enhance local wound healing by stimulating angiogenesis, collagen deposition, and re-epithelialization without systemic adverse effects. This case series included five male patients with Hansen’s disease who presented with chronic trophic ulcers or ulcerative lesions of lepra reaction. A solution of 0.1 ml Actrapid insulin diluted with 0.9 ml normal saline was irrigated directly to the ulcer surface twice daily and covered with sterile gauze for five minutes. The intervention was continued for four to six weeks. Ulcer size, depth, tissue quality, and granulation were assessed clinically and documented photographically at baseline and follow-up. All patients showed significant improvement within two weeks, with marked reduction in ulcer dimensions and healthy granulation tissue formation. Complete epithelization was achieved in four to six weeks. No local or systemic adverse effects were observed, and compliance was excellent. Topical insulin is a safe, economical, and effective therapeutic option for leprosy-associated ulcers, meriting further evaluation in larger controlled studies. PB - Nepal Journals Online (JOL) PY - 2026 SP - 54 EP - 57 T2 - Nepal Journal of Dermatology, Venereology & Leprology TI - Topical Insulin: A Game Changer for Non-Healing Leprosy Ulcers – A Case Series UR - https://nepjol.info/index.php/NJDVL/article/view/84140/71129 VL - 24 SN - 2091-167X, 2091-0231 ER -