Chronic Rhinitis: A Manifestation of Leprosy

Camacho, Ivan D.; Burdick, Anne E.; Benjamin, Latanya; Casiano, Roy R.

doi:10.1177/014556131109000915

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…Leprosy is a secondary cause of atrophic rhinitis [ 14 ]. The main characteristics of leprosy rhinitis are chronicity, the absence of acute phenomena, and the incomplete obstruction of the nasal mucosa, presenting dryness and crust-formation [ 22 ]. As the condition progresses, it frequently produces perforations of the septum, and causes the destruction of the cartilaginous part and collapse of the nasal ala [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

High prevalence of olfactory impairment among leprosy patients: A cross-sectional study

et al. 2023

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Background The effect of leprosy on the sense of smell is not yet fully established. Studies that have relied only on patients’ perceptions may have under- or over-estimated the change in smell perception. A validated and psychophysical method is necessary to avoid these errors in assessment. Objectives This study aimed to validate the existence of olfactory involvement in leprosy patients. Methods A cross-sectional, controlled study was conducted, in which individuals with leprosy (exposed individuals) and individuals without leprosy (control patients) were recruited. For each exposed individual, we selected two control patients. A total of 108 patients (72 control patients and 36 exposed individuals) with no history of infection with the new coronavirus (COVID-19) took the University of Pennsylvania Smell Identification Test (UPSIT). Results Most exposed individuals had olfactory dysfunction [n = 33, 91.7% (CI 95%: 77.5%–98.3%)] when compared with the control patients [n = 28, 38.9% (CI 95%: 27.6%-51.1%)], but only two (5.6%) had olfactory complaints. The olfactory function was significantly worse among exposed individuals [UPSIT leprosy = 25.2 (CI 95%: 23.1–27.3) when compared with the UPSIT control patients = 34.1 (CI 95%: 33.0–35.3); p<0.001]. The risk of olfactory loss was higher among the exposed individuals [OR: 19.5 (CI 95%: 5.18–105.70; p < 0.001)]. Conclusions Olfactory dysfunction was highly prevalent among exposed individuals, although they had little or no self-knowledge of the disorder. The results show that it is important to assess the sense of smell in exposed individuals.

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Section: Discussionmentioning

confidence: 99%

High prevalence of olfactory impairment among leprosy patients: A cross-sectional study

et al. 2023

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“…The distribution of these skeletal lesions reflects the cooler temperature of exposed skin and mucosa that is consistent with the well-known temperature preference of leprosy bacilli [ 11 , 20 , 49 , 54 ]. From the initial site of involvement (the nasal cavity), the leprous infection can extend to the paranasal sinuses, particularly to the maxillary ones [ 57 ]. Although not pathognomonic for Hansen’s disease, signs of sinusitis in the form of pitting and/or subperiosteal new bone formations can frequently be observed on the walls of the affected maxillary sinus(es) in cases with rhinomaxillary syndrome [ 20 , 54 , 58 , 59 ].…”

Section: Discussionmentioning

confidence: 99%

“…In KD271 , the initial site of leprous involvement could have been the nasal mucosa. Its infiltration by leprosy bacilli could have resulted in the onset of granulomatous inflammation with subsequent development of atrophic rhinitis (progressive thinning and hardening of the mucosa that lines the nasal cavity) [ 11 , 49 , 57 , 60 , 61 ]. This condition is characterised by highly bacilliferous, muco-purulent or exudative nasal discharges, crusting, intermittent epistaxis, and obstruction of the nasal airways [ 49 , 57 , 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

“…Its infiltration by leprosy bacilli could have resulted in the onset of granulomatous inflammation with subsequent development of atrophic rhinitis (progressive thinning and hardening of the mucosa that lines the nasal cavity) [ 11 , 49 , 57 , 60 , 61 ]. This condition is characterised by highly bacilliferous, muco-purulent or exudative nasal discharges, crusting, intermittent epistaxis, and obstruction of the nasal airways [ 49 , 57 , 60 , 61 ]. In the middle-aged male, the infection could have extended from the nasal mucosa to the adjacent cartilaginous and bony nasal structures (e.g., inferior nasal conchae and nasal surface of the maxillary palatine process), and paranasal sinuses (e.g., right maxillary sinus) [ 49 , 57 , 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

“…This condition is characterised by highly bacilliferous, muco-purulent or exudative nasal discharges, crusting, intermittent epistaxis, and obstruction of the nasal airways [ 49 , 57 , 60 , 61 ]. In the middle-aged male, the infection could have extended from the nasal mucosa to the adjacent cartilaginous and bony nasal structures (e.g., inferior nasal conchae and nasal surface of the maxillary palatine process), and paranasal sinuses (e.g., right maxillary sinus) [ 49 , 57 , 60 , 61 ]. In KD271 , destruction of the affected cartilaginous and bony nasal structures could have led to the development of saddle-nose deformity that is characteristic of lepromatous leprosy [ 1 , 11 , 49 , 62 ].…”

Section: Discussionmentioning

confidence: 99%

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The two extremes of Hansen’s disease—Different manifestations of leprosy and their biological consequences in an Avar Age (late 7th century CE) osteoarchaeological series of the Duna-Tisza Interfluve (Kiskundorozsma–Daruhalom-dűlő II, Hungary)

et al. 2022

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To give an insight into the different manifestations of leprosy and their biological consequences in the Avar Age of the Hungarian Duna-Tisza Interfluve, two cases from the 7th-century-CE osteoarchaeological series of Kiskundorozsma–Daruhalom-dűlő II (Hungary; n = 94) were investigated. Based on the macromorphology of the bony changes indicative of Hansen’s disease, KD271 (a middle-aged male) and KD520 (a middle-aged female) represent the two extremes of leprosy. KD271 appears to have an advanced-stage, long-standing near-lepromatous or lepromatous form of the disease, affecting not only the rhinomaxillary region but also both upper and lower limbs. This has led to severe deformation and disfigurement of the involved anatomical areas of the skeleton, resulting in his inability to perform the basic activities of daily living, such as eating, drinking, grasping, standing or walking. The skeleton of KD520 shows no rhinomaxillary lesions and indicates the other extreme of leprosy, a near-tuberculoid or tuberculoid form of the disease. As in KD271, Hansen’s disease has resulted in disfigurement and disability of both of the lower limbs of KD520; and thus, the middle-aged female would have experienced difficulties in standing, walking, and conducting occupational physical activities. KD271 and KD520 are amongst the very few published cases with leprosy from the Avar Age of the Hungarian Duna-Tisza Interfluve, and the only examples with detailed macromorphological description and differential diagnoses of the observed leprous bony changes. The cases of these two severely disabled individuals, especially of KD271 –who would have required regular and substantial care from others to survive–imply that in the Avar Age community of Kiskundorozsma–Daruhalom-dűlő II there was a willingness to care for people in need.

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