phenylephrine-hydrochloride and Leprosy

Topics: Acid-Base Equilibrium; Agglutinins; Animals; Antibody Formation; Bacterial Infections; Blood Bactericidal Activity; Blood Glucose; Body Weight; Diabetes Complications; Diabetes Mellitus; Erythrasma; Glucose Tolerance Test; Humans; Ketones; Leprosy; Leukocytosis; Nose; Phagocytosis; Rats; Skin; Skin Diseases, Infectious; Staphylococcal Infections; Urinary Tract Infections

Topics: Blood Protein Electrophoresis; Cilia; Diagnosis, Differential; Granuloma; Granuloma, Lethal Midline; Granulomatosis with Polyangiitis; Herpes Simplex; Humans; Kidney Transplantation; Leishmaniasis, Mucocutaneous; Leprosy; Lysosomes; Microscopy, Electron; Mycoses; Nasal Polyps; Nose; Postoperative Complications; Prognosis; Respiratory Tract Diseases; Rhinitis; Rhinoscleroma; Sarcoidosis; Syphilis; Transplantation, Homologous; Tuberculosis; Tuberculosis, Laryngeal

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Identification of Mycobacterium leprae is difficult in part due to the inability of the leprosy bacillus to grow in vitro. A number of diagnostic methods for leprosy diagnosis have been proposed. Both serological tests and molecular probes have shown certain potential for detection and identification of Mycobacterium leprae in patients. In this study, we have investigated whether Mycobacterium leprae DNA from the nasal secretion of healthy household contacts and the non contacts could be detected through PCR amplification as a method to study the sub clinical infection in a community. A total of 200 samples, 100 each from contacts and non contacts representing all age groups and sex were included in this study. The M. leprae specific primer (proline-rich region) of pra gene was selected and PCR was performed using extracted DNA from the sample. A total of 13 samples were found to be positive for nasal PCR for pra gene among the male and female contacts out of which 7% were males and 6% were females. Even though several diagnostic tools are available to detect the cases of leprosy, they lack the specificity and sensitivity. PCR technology has demonstrated the improved diagnostic accuracy for epidemiological studies and requires minimal time. Although nasal PCR studies have been reported from many countries it is not usually recommended due to the high percentage of negative results in the contact.

Topics: Adult; Aged; Aged, 80 and over; Asymptomatic Infections; Bodily Secretions; Child; Child, Preschool; DNA, Bacterial; Female; Humans; Infant; Leprosy; Male; Middle Aged; Molecular Diagnostic Techniques; Mycobacterium leprae; Nose; Polymerase Chain Reaction; Sensitivity and Specificity; Time Factors; Young Adult

This study compares the strains of genotypes of M. leprae from nasal secretions (NS) and skin biopsy (SB) in the same patient, supplementing conventional epidemiology to gain insight into the infection of leprosy in Fortaleza, Brazil.. The sample consisted of 38 newly diagnosed leprosy patients attending the National Reference Center of Dermatology Dona Libania (CDERM), in Fortaleza, who tested positive for M. leprae by PCR in DNA extracts of nasal secretions. DNA was also extracted from skin biopsy (SB) scrapings of each patient and used for multiplex PCR amplification of M. leprae VNTR loci. The number of repeats at 15 loci were determined by the fragment length analysis method.. Locus VNTR genotypes were achieved in 38 NS, and in 38 SB specimens.\ M. leprae strains differed in their genotypes in paired specimens in all but two of\ 38 patients. The genotype similarity in the remainder ranged from 53% to 87%.. M. leprae 15 VNTR loci genotypes of paired nasal and biopsy skin samples from five patients were identical, while as many as seven loci differed in the 33 other patients. When the NS and biopsy genotypes were pooled and compared, it was found that there was a great variability among different VNTR markers. It is important to investigate other molecular markers suitable for typing genetic variations of the bacilli.

Topics: Biopsy; Brazil; Cross-Sectional Studies; DNA, Bacterial; Endemic Diseases; Genetic Variation; Genotype; Humans; Leprosy; Minisatellite Repeats; Mycobacterium leprae; Nose; Polymerase Chain Reaction; Polymorphism, Single Nucleotide; Skin

 Leprosy persists as a public health problem. The chain of transmission and mechanism of infection are not completely understood. In the current study, we investigated the route of infection and of disease onset, from airway exposure, colonization, and bloodstream dissemination..  Mycobacterium leprae DNA was detected through quantitative polymerase chain reaction in nasal vestibule, nasal turbinate mucosa, and peripheral blood samples, along with anti-phenolic glycolipid I serology and skin tests from the same individual, from 113 leprosy patients and 104 household contacts of patients (HHCs). Bivariate statistics and multiple correspondence analysis were employed..  The rates of DNA positivity among patients were 66.4% (75 of 113) for nasal swab samples, 71.7% (81 of 113) for nasal turbinate biopsy samples, 19.5% (22 of 113) for blood samples, with seropositivity of 62.8% (71 of 113 samples) and with increasing incidences toward the multibacillary pole of the clinical spectrum. Positivity among HHCs were as follows: 49% (51 of 104) for nasal swab samples, 53.8% (56 of 104) for nasal biopsy samples, 6.7% (7 of 104) for blood samples, and 18.3% (19 of 104 samples) for anti-phenolic glycolipid I serology. During the follow-up of 5-7 years, out of 104 HHCs, 7 developed leprosy (6.7%). Risk for the disease outcome was estimated by comparing results in HHCs who develop leprosy with those not affected. Neither nasal passage nor mucosa positivity was determinant of later disease onset; however, blood presence increased the risk for disease development (relative risk/positive likelihood ratio, 5.54; 95% confidence interval, 1.30-23.62), as did seropositivity (positive likelihood ratio, 3.69 [1.67-8.16]; relative risk, 5.97 [1.45-24.5])..  Our findings strongly suggest that the aerosol route of infection and transmission is predominant and that HHCs contribute to the infection risk to themselves and probably to others.

Topics: Adolescent; Adult; Aerosols; Antibodies, Bacterial; Antigens, Bacterial; Asymptomatic Infections; Bacterial Load; Biopsy; Carrier State; DNA, Bacterial; Family Characteristics; Female; Follow-Up Studies; Glycolipids; Humans; Leprosy; Male; Middle Aged; Mycobacterium leprae; Nasal Mucosa; Nose; Polymerase Chain Reaction

Studies have demonstrated high sensibility of the polimerase chain reaction (PCR) technique in the identification of the Mycobacterium leprae DNA . This study aimed to evalue the PCR sensibility at the detection of the M. leprae DNA in nasal swab of leprosy patients and to compare the results with the bacilloscopy and multibacillary (MBs) and paucibacilares (PBs) forms. Nasal secretion samples of 24 leprosy patients were collected, and were preserved in one and two lise's solution. The PCR results were highly significant (p <0.0000) and they revealed grater sensibility than bacilloscopy, in several clinical forms. Nevertheless, still different studies are necessary, testing new markers and preservatives, with the purpose of lifting up the sensibility of this technique, in nasal secretion samples.

Topics: DNA, Bacterial; Humans; Leprosy; Mycobacterium leprae; Nasal Mucosa; Nose; Polymerase Chain Reaction; Sensitivity and Specificity

There has still been no reduction in the detection rate worldwide for leprosy, despite supervised multi-drug therapy. In time, leprosy can result in a severe saddle-nose deformity leading to functional problems, disfiguration and stigmatization. In severe cases, only the nasal skin tissue and the lower lateral cartilages are preserved. In such cases, the ideal would be to restore the cartilaginous skeleton but, by contrast with other causes of saddle-nose deformities, this is complicated by the quantity and the poor quality of the remaining nasal mucosa. Leprosy-related saddle-nose deformities are therefore challenging and difficult to reconstruct with the techniques that have been proposed in the past. In this study, 24 patients underwent rhinoplastic surgery involving the use of autogenous costal and/or auricular cartilage or composite grafts. The nasal septum, the upper laterals and the anterior nasal spine were reconstructed with a dorsal onlay attached to a columellar strut with an extension on the proximal side. Before surgery, the saddle-nose deformities were classified according to severity with a new system based on clinical symptoms and signs. Postoperative evaluation was performed at least two years after surgery (N=17). Functional and aesthetic improvement, resorption rate, warping, infection and extrusion were analysed. Functional and aesthetic improvements were achieved in 15/17 patients. None of the patients developed an infection and extrusion or warping of the implants was not observed. The resorption rate depended on the localization and the type of cartilage implant. In general, auricular conchal cartilage implant grafts resulted in less resorption than costal cartilage. Least resorption (4/17 patients) was observed in the dorsal onlay grafts of both conchal (1/6) and costal cartilage grafts (3/11). Resorption of columellar strut implants and shield grafts was observed in 7/17 patients. No resorption was seen of composite grafts (0/4) and alar battens (0/7). Autogenous cartilage implants can be used to reconstruct saddle-nose deformities in leprosy with a minimum risk of complications. The preoperative grade of severity was used as a basis for the development of guidelines for optimal long-term functional and aesthetic outcome.

Topics: Adolescent; Adult; Cartilage; Female; Humans; Leprosy; Male; Middle Aged; Nose; Nose Deformities, Acquired; Postoperative Complications; Recurrence; Rhinoplasty; Severity of Illness Index; Treatment Outcome

Topics: Extremities; Humans; Hygiene; Leprosy; Myiasis; Nose; Patient Education as Topic; Secondary Prevention; Skin

Leprosy is curable now-a-days if initiatives are taken for prevention of disability along with complete and regular chemotherapy. Common disabilities encountered in leprosy are: Claw hand, foot drop, lagophthalmos, plantar ulcers and depressed bridge of nose. Objectives of prevention of disabilities are preservation of nerve function, preservation of vision, to regain functional ability and self-esteem. Measures to prevent disabilities include early diagnosis and treatment with effective chemotherapy, to train leprosy cases to perform self-care practices, providing them with protective aids and referring the cases for surgery if indicated. Lepra reactions are episodes of sudden increase in the activity of the disease. Lepra reactions are treated by bed rest, analgesics rest to affected nerve by splints and a suggested course of prednisolone. Besides, leprosy-affected persons should be encouraged for self-care practices. Counselling and holding care and concern camps (POD camps) are very much integrated wtih the prevention of disabilities.

Topics: Activities of Daily Living; Counseling; Disabled Persons; Foot; Foot Diseases; Hand; Humans; Leprosy; Nerve Tissue; Nose; Patient Education as Topic

The number of registered leprosy patients world-wide has decreased dramatically after extensive application of WHO recommended Multiple Drug Therapy (MDT). The annual number of new cases has, however, been almost unchanged in several populations, indicating that the infection is still present at community level. Nasal carriage of Mycobacterium leprae DNA was studied in Lega Robi village in Ethiopia. MDT had been applied for more than ten years, and 718 residents over 5 years old were eligible for the study. During the first survey nasal swab samples were collected from 664 (92.5%) individuals. The results of a Peptide Nucleic Acid-ELISA test for M. leprae DNA interpreted by stringent statistical criteria were available for 589 (88.7%) subjects. Thirty-five (5.9%) individuals without clinical signs of leprosy were positive for M. leprae DNA. Seven PCR positive individuals lived in a household where one or two other members were also positive for M. leprae DNA. During a second survey 8 (46%) of 175 interpretable PNA-ELISA tests were positive. Of 137 individuals tested twice, only two were positive on both occasions whereas 10 were PCR positive only once. The study confirms the widespread distribution of M. leprae DNA in healthy individuals. The feasibility of curbing possible transmission of subclinical infection needs further consideration.

Topics: Adolescent; Adult; Aged; Carrier State; Child; DNA, Bacterial; Enzyme-Linked Immunosorbent Assay; Ethiopia; Female; Humans; Leprosy; Male; Middle Aged; Mycobacterium leprae; Nose; Polymerase Chain Reaction

Topics: Diagnosis, Differential; Humans; Leprosy; Male; Nose; Nose Deformities, Acquired; Yaws

We report here a simplified method for the detection of nasal carriage of Mycobacterium leprae. DNA extracted from nasal swabs was analyzed by PCR, and M. leprae specific amplicons detected by means of a novel peptide-nucleic-acid-ELISA (PNA-ELISA) method. Parameters for the method were established using swabs taken from untreated lepromatous leprosy patients. We have developed this method to study nasal carriage in endemic populations. However, due to the sensitivity of PCR based techniques, we wished to assess the possibility of false positive samples arising in our method. We therefore examined samples taken from individuals in Norway, a country non-endemic for leprosy, using our technique. A total of 219 nasal swabs were collected and tested in our laboratory in London. All of these were found to be negative by our criteria. In order to corroborate our results, and also to assess the specificity of the method, a small number of these samples were randomly selected, and a known amount of M. leprae DNA added to them. All 219 samples were then retested using the same techniques under "double blind" conditions in our laboratory in India. All of the samples to which M. leprae DNA had been added were successfully identified by this method whereas all other swabs were negative. Taken together, these results suggest that the technique described here is simple, sensitive, and specific for use in large-scale epidemiological studies. This study, part of the larger MILEP 2 study, represents the first use of a PNA-PCR method for an epidemiological study of infection. The method using PNA-ELISA is significantly simpler and more rapid than gel based detection methods. The supply of laboratory consumables and overall detection procedure were simplified and standardized by use of PCR Ready-to-Go beads.

Topics: DNA, Bacterial; Enzyme-Linked Immunosorbent Assay; Humans; Leprosy; Mycobacterium leprae; Nose; Nucleic Acid Hybridization; Peptide Nucleic Acids; Polymerase Chain Reaction; Sensitivity and Specificity

The saddle nose resembles a saddle, i.e., with a concave, often flattened dorsum and an apparent cephalic rotation of the nasal tip. The concavity may be present in the osseous or cartilaginous dorsum, or both. The saddle nose deformity can be divided into congenital, postinfection, postsurgical, and traumatic types. Congenital saddle nose deformity is rare, often accompanying midfacial deficiency malformation syndromes. The advent of antimicrobial therapy has helped restrict the incidence of syphilitic or leprotic saddle nose to the nonindustrialized nations. Postsurgical saddle nose deformity occurs most often as a result of the overzealous septorhinoplasty. The most common type of saddle nose deformity may be traumatic. The authors use Kazanjian and Converse's characterization of the true saddle nose as one in which the bony and/or cartilaginous portions are depressed and the projection of the nose is generally preserved. This article describes the saddle nose deformity and its etiology and proposes a management technique with minimal complications.

Topics: Adolescent; Adult; Bone Substitutes; Bone Transplantation; Cartilage; Craniofacial Abnormalities; Female; Humans; Leprosy; Male; Middle Aged; Nasal Bone; Nasal Septum; Nose; Nose Deformities, Acquired; Rhinoplasty; Rotation; Skull Fractures; Syphilis; Treatment Outcome

The SCID (severe combined immunodeficient) mouse lacks both B and T cells and tolerates injected mononuclear cells from humans, the principal hosts of Mycobacterium leprae. A SCID mouse model of leprosy could be useful to investigate potential vaccine strategies using human cells in a context in which the growth of the organism is monitored. Initial experiments determined that SCID mice are more susceptible than normal mice to infection and dissemination of M. leprae. Cells from humans, either BCG vaccinated or from countries where leprosy is endemic, were stimulated in vitro with a number of mycobacterial antigens--whole M. leprae, M. leprae cell walls, purified protein derivative of M. tuberculosis, and Mycobacterium bovis BCG--and tested for proliferation and production of interleukin-6, tumor necrosis factor alpha, and gamma interferon. Cell walls were the most efficient and consistent in inducing all of these activities. In vitro-activated human cells retain function better after injection into SCID mice than nonactivated cells. To test the ability of cells to affect the growth of M. leprae in the footpads of SCID mice, cells from a known responder to mycobacterial antigens and from a nonresponder were activated by M. leprae cell wall antigens. The cells were harvested and coinjected with fresh M. leprae into the right hind footpads of SCID mice. After 3 months, there was no growth of M. leprae in the footpads of mice coinjected with cells from the mycobacterial antigen responder, while growth was uninhibited in mice receiving cells from the nonresponder. Future experiments will determine requirements for antigen specificity in inhibiting M. leprae multiplication.

Topics: Animals; Antibodies, Bacterial; Antigens, Bacterial; Cytokines; Disease Models, Animal; Disease Susceptibility; Extremities; Humans; Immunotherapy, Adoptive; Leprosy; Leukocytes, Mononuclear; Lymphocyte Activation; Lymphoid Tissue; Lymphotoxin-alpha; Mice; Mice, Inbred Strains; Mice, SCID; Nose

The dorsum of the feet of 10 nude mice was smeared with 10(7) Mycobacterium leprae and then pricked with cactus thorns contaminated with M. leprae. In 15 months five of them developed lepromatous nodules at the infected site and disseminated lesions in the ears, nose, tail and the organs of the reticuloendothelial system. Penetrating injuries through unprotected skin contaminated with M. leprae from the environment may play a role in the transmission of leprosy in humans.

Topics: Animals; Ear, External; Foot; Granuloma; Leprosy; Liver; Lung; Mice; Mice, Nude; Nose; Skin; Spleen; Tail

Topics: Animals; Antigen-Antibody Complex; Ear; Immunosuppression Therapy; Leprosy; Mice; Mice, Inbred Strains; Nose; Skin; Thymectomy

Both ears from 494 wild nine-banded armadillos (Dasypus novemcinctus) and nose specimens from 224 animals were collected and histopathologically studied. Lepromatous granulomas were present in the ear specimens of ten of 494 animals. There were thorns in the ears of 22.5% of animals, and in 36.6% of the nose specimens. In one armadillo, there was evidence to suggest that Mycobacterium leprae entered the tissue through the thorn pricks. In the normal habitat of the armadillo in Louisiana there are thorny bushes consisting mostly of the green briar and the southern dewberry. Thorn pricks as a means of transmission of leprosy in the wild armadillos is suggested.

Topics: Animals; Armadillos; Ear; Granuloma; Leprosy; Mycobacterium leprae; Nose; Plants; Wounds, Penetrating; Xenarthra

Topics: Diagnosis, Differential; Female; Humans; Leprosy; Middle Aged; Nose; Rhinitis

Nose forms an important site at which the M. leprae in lepromatous leprosy (LL) patients lodge and multiply. Nose forms an important reservoir for M. leprae, from where they may be transmitted to healthy contacts. Inspite of realizing the above fact, nose does not normally receive due importance during the chemotherapy of leprosy. LL patients, after regular treatment with dapsone or rifampin for about 20 wks and 3 wks respectively are normally considered non-infectious. From the present investigation it is clear that local treatment of the ones with a bactericidal agent should perhaps be necessary during chemotherapy of LL patients to make them non-infectious and to control the transmission of the disease.

Topics: Clofazimine; Dapsone; Drug Therapy, Combination; Humans; Leprosy; Mycobacterium leprae; Nose; Rifampin

332 nose-blow specimens have been examined from 73 untreated multibacillary patients of leprosy before and periodically after they were put on a maximal, minimal or an intermediate multi-drug regimen. 80% of these specimens were found to be positive for acid fast bacilli initially. Bacillary positivity rate was more in samples containing pus or blood. Bacilli were seen in LL, LI as well as BL patients. Nearly half of the cases became negative for AFB in their nose-blow specimens within 3 months of initiation of treatment whereas none of these patients has become negative in skin smears. However, a few cases have continued to discharge bacilli in their nasal secretions even after 12 months of multi-drug regimen therapy.

Topics: Adolescent; Adult; Female; Humans; Leprostatic Agents; Leprosy; Male; Middle Aged; Nasal Mucosa; Nose; Respiration

Topics: Humans; Leprosy; Male; Nose; Plastics; Prostheses and Implants

A clinical, bacteriological and histopathological investigation of 62 patients with lepromatous leprosy attending a hospital in South India is reported, with particular emphasis on the activity of the disease in the nose. Twelve of the patients were from a group of 34 new patients who had been originally examined 5 years previously, and subsequently treated with dapsone (DDS) monotherapy. A further 50 lepromatous patients were also examined, who had been treated for periods ranging from 3 months to 10 years. With a few exceptions, there was good correlation between the clinical and histopathological findings in the skin and nose. Evidence of disease activity was demonstrated among three-quarters of the patients who had been treated for over a year. Failure to achieve quiescence was explained in most of the patients by failure to collect their dapsone treatment or to ingest it regularly as demonstrated by the determination of DDS/creatinine ratios on urine samples collected at the time of their visit to the clinic. Although the compliance of most patients was relatively satisfactory during the first 12 months of treatment, thereafter it deteriorated markedly. In contrast to the clinical, bacteriological, and histopathological evidence of disease activity in the skin and nose of most patients, in only one of the patients treated for more than a year was a positive nose-blow encountered. This suggests that the infectivity of DDS-treated lepromatous patients within this time and this diminished infectivity often persists despite poor drug compliance and continuing disease activity.

Topics: Dapsone; Humans; Leprosy; Nasal Mucosa; Nose; Time Factors

A series of 19 cases has been reviewed in which biopsy of an intra-nasal lesion revealed a granulomatous pathology. These have been classified on an aetiological basis. They include infections, Wegener's granuloma and neoplasms with a granulomatous stroma. One patient with sarcoidosis first presented with lesions in the nasal cavity. Cholesterol granulomata were seen in four lesions removed from the paranasal sinuses. In six cases clinical and histological examination failed to show a cause for the granulomata; in all of these patients the nasal cavity was free from disease at a subsequent examination.

Topics: Adult; Aged; Biopsy; Cholesterol; Female; Granuloma; Granulomatosis with Polyangiitis; Humans; Leprosy; Male; Middle Aged; Nose; Nose Diseases; Nose Neoplasms; Sarcoidosis; Tuberculosis

Topics: Humans; Leprosy; Mycobacterium leprae; Nose

Topics: Activities of Daily Living; Adult; Asia; Child; Cockroaches; Humans; Insect Vectors; Leprosy; Male; Mycobacterium leprae; Nose

Although the portal of entry and mode of spread of M. leprae in human leprosy are still uncertain, it is widely held that direct person-to-person skin contact is important. This assumption has ignored the fact that patients with highly bacilliferous leprosy have nasal as well as dermal infection and that, since M. leprae is shed predominantly from the nose, leprosy might be an airborne infection. The present study was designed to investigate this possibility with mice exposed to airborne infection with M. leprae. The conditions are described in which thymectomised-irradiated CBA strain mice exposed to M. leprae aerosols sustained an immediate lung retention of 1 X 10(5) bacteria. Fourteen to 24 months later, 33% (10 of 30) of the mice had countable numbers of acid-fast bacilli (greater than 2 X 10(4)) with the characteristics of M. leprae in one or more homogenates prepared from ears, foot pads, nose or lungs. Evidence is presented from the distribution of M. leprae that the infection had arisen from systemic spresd of bacilli initially entering the lungs rather than from multiplication of organisms locally retained there, or in the nose, at the time of airborne infection. The relevance of these results to the possible route of infection of leprosy in man is discussed.

Topics: Aerosols; Air Microbiology; Animals; Disease Models, Animal; Ear; Female; Foot; Leprosy; Lung; Mice; Mice, Inbred CBA; Mycobacterium leprae; Nose

The nasal and aural temperature patterns of 100 normal subjects have been investigated by infrared thermography, paying particular attention to possible errors of instrumentation and technique which may arise in such areas of complex morphology. Although by no means invariable, the pattern of themograms confirms that certain areas which are relatively cool are often affected in lepromatous leprosy, tuberculosis, leishmaniasis, and lupus pernio. In lepromatous leprosy, low temperature appears to govern the localization of disease in most parts of the body, and the possible reasons for this are discussed. Thermography may have a place in the investigation of other skin diseases in which the distribution of lesions on the body surface is unexplained.

Topics: Adult; Aged; Child; Ear; Female; Humans; Leishmaniasis; Leprosy; Male; Middle Aged; Nose; Sarcoidosis; Thermography; Tuberculosis, Cutaneous

Topics: Adult; Humans; Leprosy; Male; Mouth; Mycobacterium leprae; Nose; Sneezing

Topics: Animals; Body Temperature; Capillaries; Foreign Bodies; Granulomatous Disease, Chronic; Humans; Leprosy; Nasal Mucosa; Nose; Phagocytosis

Topics: Exudates and Transudates; Leprosy; Mycobacterium leprae; Nose; Nursing

Topics: Aged; Biopsy; Diagnosis, Differential; Face; Facial Neoplasms; Female; Fluorescent Antibody Technique; Humans; Laryngoscopy; Larynx; Leprosy; Lip; Lupus Vulgaris; Mouth; Nose; Pharynx; Potassium Iodide; Radiography; Skin; Syphilis Serodiagnosis; Syphilis, Congenital; Voice

Topics: Humans; Leprosy; Mycobacterium leprae; Nasal Mucosa; Nasal Septum; Nose; Skin; Turbinates

Topics: Cell Survival; Humans; Leprosy; Mucus; Mycobacterium leprae; Nasal Mucosa; Nose; Skin; Time Factors

Topics: Animals; Humans; Leprosy; Mycobacterium leprae; Nasal Mucosa; Nose

Topics: Animals; Disease Models, Animal; Leprosy; Mice; Mycobacterium leprae; Nasal Mucosa; Nose

Topics: Acetates; Humans; Leprosy; Menthol; Nose; Olfaction Disorders; Salicylates; Smell; Turpentine; Water

Topics: Adolescent; Adult; Eyebrows; Face; Facial Paralysis; Female; Humans; Leprosy; Lip; Male; Middle Aged; Nose; Surgery, Plastic

Topics: Animals; Axons; Basement Membrane; Capillaries; Collagen; Ear; Foot; Granuloma; Hindlimb; Humans; Leprosy; Macrophages; Median Nerve; Mice; Mice, Inbred Strains; Microscopy, Electron; Mycobacterium leprae; Myofibrils; Nerve Crush; Nose; Peripheral Nerves; Reflex, Abnormal; Schwann Cells; Sciatic Nerve; Skin; Time Factors

Topics: Face; Female; Humans; Leprosy; Lip; Methods; Nose; Surgery, Plastic

Topics: Diagnosis, Differential; History; History, 15th Century; Humans; Leprosy; Medicine in the Arts; Nose; Nose Deformities, Acquired; Poland; Sculpture; Syphilis

Topics: Black People; Diagnosis; Humans; Leprosy; Nasal Mucosa; Nasal Obstruction; Nose; Pathology

Topics: Bone Transplantation; Humans; Leprosy; Nasal Septum; Nose; Nose Deformities, Acquired; Plastics; Surgery, Plastic

Topics: Humans; Leprosy; Nasal Mucosa; Nose; Plastics; Surgery, Plastic; Surgical Flaps

Topics: Fistula; Humans; Leprosy; Nose; Paranasal Sinuses; Sinusitis

Topics: Disease; Humans; Leprosy; Maxillary Sinus; Nose; Paranasal Sinus Diseases; Sinusitis

Topics: Forehead; Humans; Leprosy; Nasal Surgical Procedures; Nose; Surgical Flaps

Topics: Humans; Larynx; Leprosy; Nose; Nose Diseases

Topics: Animals; Leprosy; Mice; Nose

Topics: Humans; Leprosy; Nasal Surgical Procedures; Nose; Rhinoplasty

Topics: Atrophy; Bone and Bones; Humans; Leprosy; Maxilla; Nose

Topics: Humans; Leishmaniasis; Leprosy; Nose

Topics: Humans; Leprosy; Leprosy, Lepromatous; Nose

Topics: Humans; Leprosy; Nose; Skin Transplantation; Surgical Flaps

Topics: Facial Transplantation; Humans; Leprosy; Nasal Surgical Procedures; Nose

Topics: Humans; Leprosy; Nasal Surgical Procedures; Nose; Rhinoplasty; Surgical Flaps

Topics: Leprosy; Nose; Sulfones

Topics: Early Diagnosis; Humans; Larynx; Leprosy; Nasopharynx; Nose; Pharyngeal Diseases

Topics: Humans; Leprosy; Neck; Nose; Pharynx; Staining and Labeling

Topics: Bone Transplantation; Humans; Leprosy; Nose

Topics: Child; Humans; Infant; Leprosy; Neck; Nose; Pharynx

Topics: Humans; Leprosy; Nose

Topics: Humans; Leprosy; Nose

Topics: Humans; Leprosy; Nose; Sexual Behavior