A Case Report: The Efficacy of Human Amniotic Membrane Mesenchymal Stem Cells-Conditioned Medium (hAMMSC-CM) for Treating Plantar Pedis Trophic Ulcer in Leprosy Patients

Leprosy is an endemic disease in many countries with consequences of neuropathy that may leads to plantar trophic ulcer. The management of trophic ulcers is difficult due to its recurrent and recalcitrant characteristics. Placental derived cells are known to release factors with potential immunomodulatory and trophic activities. In this study we use the human amniotic membrane mesenchymal stem cells-conditioned medium (hAMMSC-CM) gel to promote the wound healing of trophic ulcer. A-50-years-old female presented with a trophic ulcer over the sole of her right foot since 3 years ago. The patient gave a history of decreased sensation over the right foot and was a known case of lepromatous leprosy released from treatment 2 years back after completing multibacillary multi-drug therapy for 1 years. Cutaneous examination revealed a single non-healing ulcer over the plantar aspect of the right foot with pale granulation tissue and seropurulent discharge at the base. Touch and pain sensation were lost over the foot and up to the lower leg one-third of the leg. The result of microbiology Mycobacterium leprosy examination was bacterial index (BI) 0 and morphological index (MI) was negative. A diagnosis of plantar pedis trophic ulcer in a treated case of leprosy was made. The ulcer managed by given topical hAMMSC-CM gel and covered with transparent film dressings. Application of gel was done every 3 days, and weekly evaluation included measurement of the size and the depth of the ulcer was done. The patient was treated with hAMMSC-CM for 8 weeks. The ulcer was significantly resolved, but there was no complete healing.