Leprosy of the hard palate: A rare case report

Abstract

Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae, a bacillus that presents a peculiar tropism for the skin and peripheral nerves. Leprosy instigates various types of clinical presentation and exerts influence on the patient's immune response. The clinical gamut of leprosy ranges from the tuberculoid form (TT) to the disseminative and progressive lepromatous form (LL). Oral lesions are uncommon but, when present, occur in the lepromatous form and are broadly divided into nonspecific and specific lesions. In this article, we present a case of leprosy of the hard palate in a 25-year-old male. The case is been presented for its rarity.

Life and death of a leprosy sufferer from the 8th-century-CE cemetery of Kiskundorozsma–Kettőshatár I (Duna-Tisza Interfluve, Hungary)—Biological and social consequences of having Hansen’s disease in a late Avar Age population from Hungary

“…Because of the persistent blockage of his nasal airways, the middle-aged male could have experienced difficulties in breathing through his nose; and thus, he could have developed an oral breathing habit that is a frequent accompaniment of lepromatous leprosy [44,49,50]. As oral breathing can contribute to changes in the intraoral humidification, pH, and oxygen levels, it can have a negative impact on oral health [51].…”

“…During oral breathing, the cooling effect of the inspired air and evaporation lowers the surface temperature of certain areas in the oral cavity, such as the anterior part of the maxilla, and the soft and hard palates [49,50,55,56]. Because of the lower surface temperature, the mucous membrane of these oral sites becomes more prone to seeding by leprosy bacilli and consequently, to developing leprous lesions [49,50,56].…”

“…During oral breathing, the cooling effect of the inspired air and evaporation lowers the surface temperature of certain areas in the oral cavity, such as the anterior part of the maxilla, and the soft and hard palates [49,50,55,56]. Because of the lower surface temperature, the mucous membrane of these oral sites becomes more prone to seeding by leprosy bacilli and consequently, to developing leprous lesions [49,50,56]. Later, not only the oral mucosa but the underlying bone, such as the premaxilla and the oral surface of the maxillary palatine process, can become affected by the infection, with subsequent formation of oral bony changes (e.g., perforation of the hard palate) [36,49,50].…”

“…Because of the lower surface temperature, the mucous membrane of these oral sites becomes more prone to seeding by leprosy bacilli and consequently, to developing leprous lesions [49,50,56]. Later, not only the oral mucosa but the underlying bone, such as the premaxilla and the oral surface of the maxillary palatine process, can become affected by the infection, with subsequent formation of oral bony changes (e.g., perforation of the hard palate) [36,49,50]. In the middle-aged male, leprous involvement of both the nasal and oral surfaces of the maxillary palatine process could have terminated in perforation of the hard palate (Fig 4C and 4D).…”

Lepromatous palate perforation and its surgical repair: a case report

“…Palatal lesions include, inflammation, reddish-yellowish or reddish nodules, ulceration or perforation. 1,2,8 Due to debilitating complications of oral leprosy, it becomes important that patient should be carefully examined for bacillary aspect of leprosy where there is any suspicion about the etiology of oral lesion. 2 Oral cavity involvement in leprosy is likely to cause deformities like retraction of soft palate or perforation of hard palate.…”