Treatment and Prevention
Nodules may be excised and closed primarily. Other lesions should be widely excised and subsequently skin-grafted. Antibiotics should be given before and after surgery. Physiotherapy is often required to prevent contraction deformity, especially if the lesion crosses articulations. Photographs demonstrate en bloc excision of plaque form of BU (left), mesh autologous skin graft at site of previously excised BU, which is essential to the effective management of the disease (middle), and contraction deformity with fixation of the elbow, a result of inappropriate management of BU (right).
BCG vaccination provides short-lived prophylaxis. Neonatal BCG seems to inhibit dissemination of the disease to bone.
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