Correspondence
Rapid molecular diagnosis of chronic skin ulcers Oriol Mitjà and colleagues1 provide insight into the cause of chronic skin ulcers in a yaws-endemic area of Papua New Guinea. PCR was used to detect Haemophilus ducreyi in swabs collected from chronic skin ulcers. Conventional microbiological techniques, such as isolation of fastidious microorganisms by culture, are time-consuming and difficult. The investigators show the usefulness of the PCR technique to diagnose H ducreyi infection. Clinicians should consider this previously unrecognised causative agent of skin ulcer in children living in a yawsendemic area.
www.thelancet.com/lancetgh Vol 2 July 2014
Sally Roberts and Susan Taylor 2 summarise some facts on the diagnosis and treatment of skin ulcers. Accurate diagnosis and laboratory confirmation are important for clinicians to provide timely therapy. Without a point-of-care test, empirical use of antimicrobials can lead to drug resistance.2 Therefore, there is a need for a diagnostic technique that does not involve costly equipment and that can be used even in remote areas. The development of a multiplex3 loop-mediated isothermal amplification 4 (LAMP) assay can identify many causative agents in a single reaction and within a short time, without a thermocycler and gel documentation system. Thus, LAMP could have future application as a point-of-care test for the diagnosis of chronic skin ulcers.
We declare no competing interests. Copyright © Pahil et al. Open Access article disrtibuted under the terms of CC BY-NC-ND.
Sapna Pahil, *Kapil Goyal
[email protected] Departments of Medical Microbiology and Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India 1
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Mitjà O, Lukehart SA, Pokowas G, et al. Haemophilus ducreyi as a cause of skin ulcers in children from a yaws-endemic area of Papua New Guinea: a prospective cohort study. Lancet Glob Health 2014; 2: e235–41. Roberts SA, Taylor SL. Haemophilus ducreyi: a newly recognised cause of chronic skin ulceration. Lancet Glob Health 2014; 2: e187–88. Orle KA, Gates CA, Martin DH, Body BA, Weiss JB. Simultaneous PCR detection of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus types 1 and 2 from genital ulcers. J Clin Microbiol 1996; 34: 49–54. Tomita N, Mori Y, Kanda H, Notomi T. Loop-mediated isothermal amplification (LAMP) of gene sequences and simple visual detection of products. Nat Protoc 2008; 3: 877–82.
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