“…consider that "rhinomaxillary syndrome" is pathognomonic of lepromatous leprosy only when the full spectrum of lesions is present, but this is not the case of either skeleton 3 or 6. Even if this were the case the pathognomonic value of this syndrome is not consensual because this anatomical region may be involved in many other disease processes such as mucocutaneous leishmaniasis (Herwaldt, 1999;Manchester, 1994;Aufderheide and Rodríguez-Martín, 1998;Ortner, 2003;Malekpour and Esfandbod, 2010;Marsteller et al, 2011), neoplasms (Hackett, 1976;Aufderheide and Rodríguez-Martín, 1998;Ortner, 2003;Eggesbø, 2012;Koivunen et al, 2012), rhinoscleroma (Becker et al, 1981;Pontual et al, 2008), rhinosporidiosis (Bonifaz et al, 2011), sarcoidosis (Manchester, 1994;Mrówka-Kata et al, 2010), systemic mycosis (Zargari and Elpern, 2009;Bonifaz et al, 2011), treponematosis (Hackett, 1976;Manchester, 1994;Aufderheide and Rodríguez-Martín, 1998;Cook, 2002;Ortner, 2003;Cook andPowell, 2005, 2012), tuberculosis (lupus vulgaris) (Manchester, 1994;Ortner, 2003Ortner, , 2008aRoberts and Buikstra, 2003;Garg et al, 2010), and Wegener's granulomatosis (Chauhan and Cruz, 2007). It must be noted, however, that according to Manchester (1994: 80), in what concerns the interpretation of rhinomaxillary lesions only leprosy, tuberculosis (lupus vulgaris) and treponematosis "are of practical significance in paleopathological differential diagnoses.…”