The oral cavity in leprosy: what clinicians need to know

Abstract

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, a bacillus that has a tropism for skin and peripheral nerves. Leprosy treatment is based on a multidrug therapy established by the World Health Organization in 1982 and, despite its widespread use, Brazil ranks second worldwide in numbers of cases. Oral involvement in leprosy has been poorly described in the literature, and few studies have shown that although the bacillus is found in mucosa, specific leprosy lesions are rare and affect patients with advanced stages of the disease. This review aimed to assess the literature on oral manifestations in leprosy and the aspects involving oral cavity in leprosy pathogenesis.

Oral health conditions in leprosy cases in hyperendemic area of the Brazilian Amazon

“…The high use of dental services by leprosy patients from Cacoal indicate that these individuals care about their oral health. However, there is a need for special care in this population 31 , 32 .…”

Dependence on others for oral hygiene and its association with hand deformities and functional impairment in elders with a history of leprosy

“…This occurs through impaired sensation leading to trauma and secondary infection (including osteomyelitis), which causes tissue damage . Any form of leprosy can result in facial lesions, which follow the spectrum of clinical manifestations, varying from localised, well‐defined, hypopigmented macules or plaques to multiple nodules coalescing in plaques on the forehead, ears, nose and lips . The loss of eyebrows and eyelashes, diffuse thickening of the facial skin and deepening of natural facial lines can occur in advanced stages.…”

“…Some reports on oral lesions in leprosy have described nonspecific lesions, including erythematous candidiasis, fissured tongue and inflammatory fibrous hyperplasia. Leprosy‐specific oral lesions are uncommon and, when present, occur in patients with advanced stages of the lepromatous form …”

“…1 Any form of leprosy can result in facial lesions, which follow the spectrum of clinical manifestations, varying from localised, well-defined, hypopigmented macules or plaques to multiple nodules coalescing in plaques on the forehead, ears, nose and lips. 9 The loss of eyebrows and eyelashes, diffuse thickening of the facial skin and deepening of natural facial lines can occur in advanced stages. Some reports on oral lesions in leprosy have described nonspecific lesions, including erythematous candidiasis, fissured tongue and inflammatory fibrous hyperplasia.…”

“…Leprosy-specific oral lesions are uncommon and, when present, occur in patients with advanced stages of the lepromatous form. 9,10 The advent of multidrug therapy and the use of anti-inflammatory therapies have improved long-term health outcomes for individuals diagnosed with leprosy, but are not sufficient to prevent some of its complications, including a lifelong stigma associated with having had the disease, leprosy reactions, and occasional and permanent disability. 1,11 In Brazil, an isolationist model was adopted as a prophylactic measure and persisted until the 1980s, when residents were directed to leave the colonies.…”