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Title: Lepromatous leprosy: a review and case report
Author: Chimenos Küstner, Eduardo
Pascual Cruz, Montserrat
Piñol Dansis, Cristina
Viñals Iglesias, Helena
Rodríguez de Rivera Campillo, Ma Eugenia
López López, José, 1958-
Keywords: Lepra
Diagnòstic diferencial
Malalties infeccioses
Malalties de la boca
Differential diagnosis
Communicable diseases
Mouth diseases
Issue Date: 1-Nov-2006
Publisher: Medicina Oral SL
Abstract: Leprosy is a contagious and chronic systemic granulomatous disease caused by Mycobacterium leprae (Hansen"s bacillus). It is transmitted from person to person and has a long incubation period (between two and six years). The disease presents polar clinical forms (the"multibacillary" lepromatous leprosy and the"paucibacillary" tuberculoid leprosy), as well as other intermediate forms with hybrid characteristics. Oral manifestations usually appear in lepromatous leprosy and occur in 20-60% of cases. They may take the form of multiple nodules (lepromas) that progress to necrosis and ulceration. The ulcers are slow to heal, and produce atrophic scarring or even tissue destruction. The lesions are usually located on the hard and soft palate, in the uvula, on the underside of the tongue, and on the lips and gums. There may also be destruction of the anterior maxilla and loss of teeth. The diagnosis, based on clinical suspicion, is confirmed through bacteriological and histopathological analyses, as well as by means of the lepromin test (intradermal reaction that is usually negative in lepromatous leprosy form and positive in the tuberculoid form). The differential diagnosis includes systemic lupus erythematosus, sarcoidosis, cutaneous leishmaniasis and other skin diseases, tertiary syphilis, lymphomas, systemic mycosis, traumatic lesions and malignant neoplasias, among other disorders. Treatment is difficult as it must be continued for long periods, requires several drugs with adverse effects and proves very expensive, particularly for less developed countries. The most commonly used drugs are dapsone, rifampicin and clofazimine. Quinolones, such as ofloxacin and pefloxacin, as well as some macrolides, such as clarithromycin and minocyclin, are also effective. The present case report describes a patient with lepromatous leprosy acquired within a contagious family setting during childhood and adolescence
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It is part of: Medicina Oral, Patología Oral y Cirugia Bucal, 2006, vol. 11, num. 6, p. 474-479
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ISSN: 1698-4447
Appears in Collections:Articles publicats en revistes (Odontoestomatologia)

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