A Clinical Study of the Mouth in Untreated Lepromatous Patients

Abstract

The mouth in 40 consecutive, unselected bacilliferous leprosy patients has been examined. The fr equency and various types of lesion are reported. Twenty-three patients showed lesions inside the mouth. Although all parts of the mouth were found. to be affected in a varying percentage of patients, the hard palate was involved in ali 23 patients. Further, of these 23 patients, 21 showed acid-fast bacilli on the surface of mouth as judged by surface smears and mouthwash. A review of the literature concerning oral lesions in lepromatous' leprosy is also presented.

Oro-facial aspects of leprosy: Report of two cases with literature review

“…The main oral cavity sites of leprosy include the gingiva in the anterior portion of the maxilla, the hard and soft palate, the uvula, and the tongue (3). The sequence of pathological alterations follow the pattern as described: congestion, infiltration, formation of nodules, possible ulceration, atrophy and fibrosis (4,9). In the first case there was complete healing of the lesions after the commencement of treatment with multiple drug therapy regimens.…”

“…Oral mucosal lesions are seen in about 20-60% cases of lepromatous leprosy, while they are quite rare in tuberculoid and borderline forms. The lesions are proportional to the duration of disease, indicating that these are late manifestations (3,4). The oral lesions are generally asymptomatic and secondary to nasal changes.…”

Leprosy Specific Orofacial Aspects

“…[21][22][23] The most frequently affected site is the hard palate. 13,22,24,25 The greater prevalence in men could be explained by the fact that women seek doctor's advice earlier, perhaps for esthetical reasons. 23,26 In the advanced stages, there may be deformities and functional alterations, such as fibrosis and retraction of the soft palate or perforation of the hard palate, with serious disturbances in phonation, and nasal regurgitation of food.…”

A mucosa oral na hanseníase: um estudo clínico e histopatológico

“…This is in accordance with Port (1965) 6 and Brazil et al (1974) 8 when they state that no lesion in the oral cavity is pathognomonic of leprosy. These lesions should be biopsied and analyzed histopathologically; the association of acid-alcohol resistant bacilli and a 8,9 . Few authors did histopathological examination of detected lesions 10,12,13,16 .This may be one of the explanations for the disagreement in frequency rates of oral involvement in leprosy seen in literature, which varies from absent up to 57.5% [4][5][6][7][8][9][10][11] .…”

“…The oral cavity may be contaminated by bacilli present in rhinopharyngeal secretions, however, notwithstanding this contamination, oral cavity is resistant to lesions. These are almost only restricted to multibacillar patients in advanced stages of disease [4][5][6][7][8][9][10][11] , which suggests that bacillary invasion of the oral cavity results from bacillemia from bacterial dissemination and multiplication 12,13 . However, the oral cavity with no evident injuries may be affected in less advanced stages of the disease.…”