A Clinical Study of the Nose in Lepromatous Leprosy

Abstract

l. l. Group of Hospita is, Bombay, lndia Forty-five scrotal skin and underlying dartos biopsies from leprosy patients of varying types, duration and treatment status were examined for quantitative bacteriology and qualitative histology. 33% on homogenization and 34% on histology were positive for acid fast bacilli. The average bacillary loadjg of positive tissue was 1.5 X 10 7 45% of scrotal biopsies were positive against 42% of the skin patch when examined for qualitative changes diagnostic of leprosy. These changes were more marked in the scrotal biopsies in the borderline and lepromatous types. They were chiefly restricted to the neurovascular bundles with unaffected smooth muscle. A stained smear obtained from scrotal skin homogenate is recommended for bacteriological diagnosis as a superior method than routine multi pie skin smears or nasal scraping. Repeated use of scrotal biopsies is emphasized when frequent observations of neurological changes are necessary.

Estudo retrospectivo de dez anos em endoscopia das cavidades nasais de pacientes com hanseníase

“…In addition to infiltration and presence of blood on the mucosa of nasal cavities, we could identify the presence of crusts (Photos 1, 2 and 4) at the nasal endoscopy of 54 patients, representing 31.2% of the 173; it was also a frequent finding in the study by Barton (1974) 5 , who found it in 74% of the 77 studied patients, by Fokkens et al (1998) 22 , who found 62% among the 40 studied patients, and by Srinivasan Photo 1. LL presentation with septal anterior-inferior damage, presence of vasculitis, dryness, infiltration, mucosa hyperemia, crusts and blood spots.…”

“…3,[5][6][7] We can also note the importance of nasal mucous in the transmission of the infection, which may be a primordial factor for the dissemination of the disease, but other paths may be involved. The nasal mucosa is considered as entry and exit doors for Mycobacterium leprae in many cases considering how vulnerable the openings are and the free access to the bacilli.…”

“…Brazil has an agreed goal with WHO to reduce the prevalence rate to less than one case of Leprosy per 10,000 inhabitants by 2005. 3,6,[7][8][9][10][11] The diagnosis is made by clinical history and dermatological-neurological exam, complemented by tests and laboratory exams, such as bacilloscopic examination, performed in all patients with clinical suspicion of the condition. The sites of material collection are areas that have sensitivity affection or active lesions, such as smear of active lesion or area with sensitivity abnormalities.…”

“…After two weeks from onset of treatment, the Hansen patient is not longer infecting. [2][3][4][5][6][7][8][9][10] As to nasal manifestations of the disease, Leloir (1886) 13 referred to the affection of nasal, mouth, throat, larynx and eye mucosa, which could be invaded since the beginning of skin tuberous eruption, especially of the nose.…”

Drug Compliance in the Treatment of Leprosy

“…36 However, because a single dose of 100 mg dapsone results in serum and tissue drug concentrations that are approximately 500-fold in excess of its minimal inhibitory concentration against My cobacterium Zeprae and since the relatively long half-life of dapsone is such that inhibitory con centrations of the drug are probably maintained for about 10 days,28 it is clear that the failure to self-administer dapsone must be extremely prolonged before it results in clinical and bacteriological relapse caused by the renewed multi plication of fully dapsone-sensitive M. Zeprae. Such a conclusion is strengthened by the observation that over the short term the response of a small group of patients treated with a dose of 1 mg dapsone/day was indistinguishable from that routinely observed with standard 50 or 100 mg daily dosesY…”