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S20: Clinical evolution of patient 21 (laboratory confirmed ulcer of the left medial lower leg). Excisions and skin grafts were performed around the third and sixth ...

enrolment

week 1

week 2

week 4

week 6

heat treatment end (48 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+ 21 d)

24 month FU

S1: Clinical evolution of patient 1 (laboratory confirmed ulcer of the left anterior lower arm). A skin graft was performed in the first and third month after completion of heat treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (35 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+ 44 d)

24 month FU (+10 days)

S2: Clinical evolution of patient 2 (NOT laboratory confirmed ulcer of the right medial ankle). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (34 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+33 days)

24 month FU (+13 days)

S3: Clinical evolution of patient 3 (laboratory confirmed ulcer of the right lateral elbow). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (40 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+31 days)

24 month FU

S4: Clinical evolution of patient 4 (laboratory confirmed ulcer of the left lateral lower leg). A skin graft was performed after completion of heat treatment. Treatment failure was declared when a local new lesion was noticed at the six months follow-up. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (48 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+24 days)

24 month FU

S5: Clinical evolution of patient 5 (laboratory confirmed ulcer of the right lateral lower leg). A skin graft was performed after completion of heat treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (39 d)

week 8

1 month FU (-1 day)

2 month FU

3 month FU

6 month FU

12 month FU (+39 days)

24 month FU (+5 days)

S6: Clinical evolution of patient 6 (NOT laboratory confirmed ulcer of the left lateral lower leg). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (37 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+38 days)

24 month FU (+4 days)

S7: Clinical evolution of patient 7 (laboratory confirmed ulcer of the right posterior upper arm). A skin graft was performed after completion of heat treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (48 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S8: Clinical evolution of patient 8 (laboratory confirmed ulcer of the left medial ankle). Treatment failure was declared when the lesion deteriorated in the follow-up period subsequent to a surgical debridement. A skin graft was performed after month six. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (34 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+43 days)

24 month FU (+11 days)

S9: Clinical evolution of patient 9 (laboratory confirmed ulcer of the left lateral wrist). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (39 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+83 days)

24 month FU (+4 days)

S10: Clinical evolution of patient 10 (NOT laboratory confirmed ulcer of the right posterior upper arm). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (40 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+31 days)

24 month FU

S11: Clinical evolution of patient 11 (laboratory confirmed ulcer of the right medial upper arm). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (39 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+82 days)

24 month FU (+3 days)

S12: Clinical evolution of patient 12 (laboratory confirmed ulcer of the left lateral ankle). Skin grafts were performed before the two months and after the six months follow-up. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (40 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU (+4 days)

S13: Clinical evolution of patient 14 (laboratory confirmed ulcer of the right lateral ankle). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (46 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S14: Clinical evolution of patient 15 (laboratory confirmed ulcer of the left anterior knee). A skin graft was performed in the first month after completion of heat treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (46 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+24 days)

24 month FU

S15: Clinical evolution of patient 16 (laboratory confirmed ulcer of the left posterior elbow). A skin graft was performed in the first month after completion of heat treatment. Picture dates +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

heat treatment end (28 d)

week 6

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+39 days)

24 month FU (+5 days)

S16: Clinical evolution of patient 17 (laboratory confirmed ulcer of the right lateral upper leg). A local new lesion was noticed at the two months follow-up. It healed under wound care alone. Picture dates +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (43 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+17 days)

24 month FU

S17: Clinical evolution of patient 18 (laboratory confirmed ulcer of the right ulnar lower arm). Treatment failure was declared when the lesion deteriorated in the follow-up period subsequent to a surgical debridement. A skin graft was performed after month six. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (35 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S18: Clinical evolution of patient 19 (laboratory confirmed ulcer of the left dorsolateral foot). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (41 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU (+23 days)

S19: Clinical evolution of patient 20 (laboratory confirmed ulcer of the right posterior upper arm). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S20: Clinical evolution of patient 21 (laboratory confirmed ulcer of the left medial lower leg). Excisions and skin grafts were performed around the third and sixth month after heat treatment. Treatment failure was declared because of a distant new lesion noticed in the eighth month of follow-up. The patient developed an additional distant new lesion after antibiotic treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (41 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S21: Clinical evolution of patient 22 (laboratory confirmed ulcer of the right dorsolateral foot). A local new ulcer developed in the second month after completion of heat treatment. It healed within one month under wound care only. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (41 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S22: Clinical evolution of patient 23 (laboratory confirmed ulcer of the right medial ankle). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (43 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S23: Clinical evolution of patient 24 (laboratory confirmed ulcer of the right dorsomedial upper arm). Two weeks after the end of heat treatment the patient, known to suffer from epilepsia, endured a seizure resulting in a fatal cranial injury. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (41 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+4 days)

24 month FU

S24: Clinical evolution of patient 25 (laboratory confirmed ulcer of the right posterior shoulder). After the first week of treatment a blister became visible, which had virtually healed one week later. At the six months follow-up a new lesion was noticed in close proximity to the primary lesion. The patient declined diagnostic procedures and re-hospitalization and the lesion healed under home based wound care without additional interventions. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S25: Clinical evolution of patient 26 (laboratory confirmed ulcer of the right posterior hand). In the first and second month after heat treatment an excision and skin graft were performed. A nodule above the medial elbow, that was noticed at enrolment and later confirmed to contain M. ulcerans, healed without heat application to this site. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (40 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S26: Clinical evolution of patient 27 (laboratory confirmed ulcer of the left posterior upper leg). In the first and second month after heat treatment a debridement and skin graft were performed. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (41 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S27: Clinical evolution of patient 28 (laboratory confirmed ulcer of the left anterior upper leg). In the first and second month after heat treatment a debridement and skin graft were performed. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU (-17 days)

12 month FU

24 month FU (+469 days)

S28: Clinical evolution of patient 29 (laboratory confirmed ulcer of the left anterior upper leg). After completion of heat treatment a local new lesion was excised. Histology did not reveal any evidence for an ongoing M. ulcerans infection. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (54 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU (+27 days)

S29: Clinical evolution of patient 30 (laboratory confirmed ulcer of the right lateral ankle). An excision and skin graft were performed in the second month after completion of heat treatment. Subsequently a chronic wound developed at the epithelial transition zone between plantar and dorsal foot as surgical complication unrelated to BU. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (44 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU (-7 days)

12 month FU

24 month FU

S30: Clinical evolution of patient 31 (laboratory confirmed nodule of the right radial wrist). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (54 d)

1 month FU

2 month FU

3 month FU

6 month FU (-22 days)

12 month FU

24 month FU

S31: Clinical evolution of patient 32 (laboratory confirmed ulcer of the left posterior elbow). A debridement and skin graft were performed in the first month after completion of heat treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

heat treatment end (32 d)

week 6

week 8

1 month FU

2 month FU

3 month FU

6 month FU (-6 days)

12 month FU

24 month FU (+39 days)

S32: Clinical evolution of patient 33 (laboratory confirmed ulcer of the left dorsolateral upper leg). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1 (-1 day)

week 2

week 4

week 6

heat treatment end (56 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S33: Clinical evolution of patient 34 (laboratory confirmed ulcer of the right ulnar lower arm). A nodule at the posterior elbow, that was noticed at enrolment and later confirmed to contain M. ulcerans, ulcerated and healed without heat application to this site. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (56 d)

1 month FU

2 month FU

3 month FU

6 month FU (+16 days)

12 month FU

24 month FU

S34: Clinical evolution of patient 35 (laboratory confirmed ulcer of the left dorsal hand). After completion of heat treatment a local new lesion was excised. Histology did not reveal any evidence for an ongoing M. ulcerans infection. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (53 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S35: Clinical evolution of patient 37 (NOT laboratory confirmed ulcer of the left posterior upper arm). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S36: Clinical evolution of patient 38 (laboratory confirmed ulcer of the right buttocks). Treatment failure was declared, when the lesion - after initially closing under heat treatment - reopened several times in the follow-up period. The patient developed an additional distant new lesion under antibiotic treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU (+23 days)

S37: Clinical evolution of patient 39 (laboratory confirmed ulcer of the right buttocks). An excision was performed in the second month of follow-up. Histology did not reveal any evidence for an ongoing M. ulcerans infection. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (50 d)

1 month FU

2 month FU

3 month FU

6 month FU (+3 days)

12 month FU (+88 days)

24 month FU

S38: Clinical evolution of patient 40 (NOT laboratory confirmed ulcer of the right lateral lower leg). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (54 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+66 days)

24 month FU (+166 days)

S39: Clinical evolution of patient 41 (NOT laboratory confirmed ulcer of the left dorsal foot). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU (-10 days)

S40: Clinical evolution of patient 43 (laboratory confirmed ulcer of the right dorsal knee). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+39 days)

24 month FU (+112 days)

S41: Clinical evolution of patient 45 (laboratory confirmed ulcer of the right medial lower leg). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (54 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S42: Clinical evolution of patient 46 (laboratory confirmed ulcer of the right posterior elbow). A skin graft was performed before the sixth month after completion of heat treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S43: Clinical evolution of patient 48 (laboratory confirmed ulcer of the left anterior elbow). Treatment failure was declared because of a persitent, close to circular induration after completion of heat treatment. In addition to standard antibiotic treatment an excision and skin graft were performed. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU (-23 days)

12 month FU (+167 days)

24 month FU

S44: Clinical evolution of patient 49 (laboratory confirmed ulcer of the right posterior upper arm). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (50 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S45: Clinical evolution of patient 50 (NOT laboratory confirmed ulcer of the left dorsal foot). A debridement and direct suturing of the wound were performed in the third month after completion of heat treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (50 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S46: Clinical evolution of patient 51 (laboratory confirmed ulcer of the right ulnar hand). The patient was excluded for non compliance, when he increasingly skipped treatment sessions after significant improvement of the lesion under heat treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S47: Clinical evolution of patient 52 (laboratory confirmed ulcer of the right dorsal elbow). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S48: Clinical evolution of patient 54 (laboratory confirmed ulcer of the left lateral ankle). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (40 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU (+126 days)

24 month FU

S49: Clinical evolution of patient 55 (NOT laboratory confirmed ulcer of the right lateral lower leg). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S50: Clinical evolution of patient 56 (laboratory confirmed ulcer of the left posterior elbow). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S51: Clinical evolution of patient 57 (laboratory confirmed ulcer of the right medial ankle). The patient was simultaneously suffering from a varicouse vein above the ulcer, which continued to interfere with wound healing after clinical and microbiological cure from M. ulcerans. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S52: Clinical evolution of patient 58 (laboratory confirmed ulcer of the left medial lower leg). A delay in wound healing was addressed by a debridement and skin graft before the 12 months follow-up. Histology did not reveal any evidence of ongoing M. ulcerans infection. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (46 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU (+28 days)

12 month FU

24 month FU (+57 days)

S53: Clinical evolution of patient 59 (laboratory confirmed ulcer of the right medial lower leg (target lesion) and the right dorsal foot). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S54: Clinical evolution of patient 60 (laboratory confirmed ulcer of the left lateral ankle). Treatment failure was declared because of a local new lesion developing in the third month after completion of heat treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (54 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S55: Clinical evolution of patient 61 (laboratory confirmed ulcer of the left dorsal hand). Treatment failure was declared because of a deterioration of the primary lesion in the follow-up period. The parents declined standard antibiotic treatment and the patient healed under wound care only. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (51 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU (+6 days)

S56: Clinical evolution of patient 62 (laboratory confirmed ulcer of the left lateral shoulder). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU (+ 24 days)

12 month FU

24 month FU

S57: Clinical evolution of patient 63 (laboratory confirmed ulcer of the right medial lower leg). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU (- 3 days)

12 month FU (+63 days)

24 month FU

S58: Clinical evolution of patient 64 (laboratory confirmed ulcer of the left dorsal lower arm). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

heat treatment end (37 d)

week 8

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S59: Clinical evolution of patient 65 (laboratory confirmed ulcer of the left ulnar lower arm). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (54 d)

1 month FU

2 month FU

3 month FU

6 month FU (+18 days)

12 month FU

24 month FU

S60: Clinical evolution of patient 66 (laboratory confirmed ulcer of the right posterior lower arm). Treatment failure was declared because of a distant new lesion developing 19 months after the end of heat treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (54 d)

1 month FU

2 month FU

3 month FU

6 month FU (-5 days)

12 month FU

24 month FU

S61: Clinical evolution of patient 67 (laboratory confirmed ulcer of the left lateral ankle). Treatment failure was declared because of a local new lesion developing within six months after completion of heat treatment. The patient developed an additional new lesion after antibiotic treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU (-14 days)

12 month FU

24 month FU

S62: Clinical evolution of patient 68 (laboratory confirmed ulcer of the right ulnar lower arm). A skin graft was performed after completion of heat treatment. Treatment failure was declared because of a local new lesion developing within six months. The patient developed an additional distant new lesion after antibiotic treatment. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (55 d)

1 month FU

2 month FU

3 month FU

6 month FU (-14 days)

12 month FU

24 month FU

S63: Clinical evolution of patient 69 (laboratory confirmed ulcer of the left posterior elbow). A skin graft was performed after completion of heat treatment. A local new lesion healed under wound care alone. After several symptom-free months treatment failure was declared because of additional distant new lesions and osteomyelitis. Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (52 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S64: Clinical evolution of patient 70 (NOT laboratory confirmed ulcer of the right dorsolateral foot). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

enrolment

week 1

week 2

week 4

week 6

heat treatment end (56 d)

1 month FU

2 month FU

3 month FU

6 month FU

12 month FU

24 month FU

S65: Clinical evolution of patient 72 (NOT laboratory confirmed ulcer of the left lateral lower leg). Picture dates: +/- 2 d (heat treatment), +/- 15 d (1-3 m), +/- 30 d (6 m) and +/- 60 d (12 + 24 m). Deviations as indicated.

patient 4 (blister)

patient 5 (pustules)

patient 7 (blister)

patient 10 (blister)

patient 11 (blister)

patient 14 (blister)

patient 18 (blister)

patient 25 (blister)

patient 48 (blister)

patient 52 (blister)

patient 58 (blister)

patient 60 (blister)

S66: Images of adverse events (AE) during heat treatment. All resolved completely.