An update on the diagnosis and treatment of leprosy

Moschella, Samuel L.

doi:10.1016/j.jaad.2003.11.072

Cited by 141 publications

(119 citation statements)

References 14 publications

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“…Leprosy, caused by Mycobacterium leprae, is a slowly progressive highly infective disease with low pathogenicity and virulence [1]. Adults are relatively non-susceptible with conjugal leprosy affecting only 5% of those at risk [2].…”

Section: Diagnosis and Discussionmentioning

confidence: 99%

“…The incubation is typically 2-5 years but may be as long as 10-15 years. With the implementation of MDT, the number of active cases has dropped from 10 to 12 million in the 1980's to less than 2 million presently [1,3]. The disease is predominantly seen in the tropics and sub-tropics, especially India and Brazil [1,3].…”

Section: Diagnosis and Discussionmentioning

confidence: 99%

“…With the implementation of MDT, the number of active cases has dropped from 10 to 12 million in the 1980's to less than 2 million presently [1,3]. The disease is predominantly seen in the tropics and sub-tropics, especially India and Brazil [1,3]. The exact mechanism of transmission is not completely understood but is speculated that droplet infection may play a role because of the large number of organisms found in nasal secretions [2][3][4][5].…”

Section: Diagnosis and Discussionmentioning

confidence: 99%

“…The exact mechanism of transmission is not completely understood but is speculated that droplet infection may play a role because of the large number of organisms found in nasal secretions [2][3][4][5]. When infection occurs the cooler parts of the body are preferentially affected, most notably the skin, superficial peripheral nerves, nasal cavity and palate [1][2][3][4].…”

Section: Diagnosis and Discussionmentioning

confidence: 99%

“…Unlike tuberculosis, HIV has not had a significant impact on the worldwide incidence of leprosy [1]. The World Health Organization (WHO), as reported by Moschella [1], defines a case of leprosy, in an untreated individual, as a person having one or more of the following 3 cardinal signs: (1) hypopigmented or erythematous skin lesions with loss of sensation, (2) thickening of peripheral nerves and (3) loss of sensation, or skin smear positive for acid-fast bacilli. Ridley and Jopling [6] classified leprosy into a 5 group system based on the immunologic response of the host.…”

Section: Diagnosis and Discussionmentioning

confidence: 99%

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Section: Diagnosis and Discussionmentioning

confidence: 99%

Section: Diagnosis and Discussionmentioning

confidence: 99%

Section: Diagnosis and Discussionmentioning

confidence: 99%

Section: Diagnosis and Discussionmentioning

confidence: 99%

Section: Diagnosis and Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical–Pathological Conference: Case 3

Hall

Torske

Kahn

et al. 2010

Head and Neck Pathol

Self Cite

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Multiple Congenital Facial Papules—Quiz Case

Agim

Hunt²,

Williams³

et al. 2011

Arch Dermatol

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Possible cases of leprosy and tuberculosis in medieval Sigtuna, Sweden

Kjellström¹

2010

Intl J of Osteoarchaeology

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In Sigtuna, Sweden, a medieval cemetery, including 227 skeletons, was analysed in 2006. On the outskirts of the churchyard, six skeletons with bone changes indicating systemic inflammatory disease were observed. Two out of three individuals with well-preserved facial bone regions displayed signs of rhinomaxillary remodelling. Four of the afflicted exhibit severe bilateral alterations of the lower legs and phalanges of the feet and concentric atrophy of the metatarsals. In addition, one of the individuals exhibited a kyphosis in the lumbar vertebrae. In a discussion about alternative diagnoses, lepromatous leprosy and tuberculosis were identified as the causes of the destructive lesions in two individuals. Though the skeletal changes of the lower legs and feet in four cases demonstrate a close resemblance to secondary lesions of leprosy, the disease could not be confirmed. The skeletal changes of the last individual were unspecific and the possible causes several, rendering diagnosis difficult. The burial locations imply that the afflicted persons belonged to a lower social stratum. Due to the significantly higher frequency of pathological changes in the cemetery compared to other cemeteries in the town, the individuals could be regarded as fellow sufferers among others with various medical conditions. The bioarchaeological identification of systemic infectious diseases of a group of individuals of this size is unique to Q1 north Q1 of Scania in Sweden, where only a few cases of leprosy and tuberculosis have previously been diagnosed. The significance of the present study is emphasised by the interconnection between the afflicted, the archaeological context and the knowledge of the medieval society in Sigtuna.

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An update on the diagnosis and treatment of leprosy

Cited by 141 publications

References 14 publications

Clinical–Pathological Conference: Case 3

Clinical–Pathological Conference: Case 3

Multiple Congenital Facial Papules—Quiz Case

Possible cases of leprosy and tuberculosis in medieval Sigtuna, Sweden

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