The Forgotten Infection Cases: Leprosy Disease Oral Manifestations and Its Problem
Abstract
Background: Leprosy, an infectious disease caused by Mycobacterium leprae, predominantly affects the skin, peripheral nerves, and mucous membranes. Although highly contagious, most people are naturally resistant. Indonesia ranks third globally in leprosy cases, and the disease continues to pose a significant public health challenge. This report aims to highlight the oral manifestations of leprosy in order to aid in early detection and treatment, which are essential to prevent disability and stigma. Case(s): Five patients diagnosed with borderline lepromatous or lepromatous leprosy were examined. Their oral manifestations included gingivitis, periodontitis, ulceration, desquamation, anesthesia, and hypopigmented lesions. Some patients exhibited poor oral hygiene, which exacerbated their symptoms. Each patient was undergoing multidrug therapy with rifampicin, dapsone, and clofazimine, along with additional medications based on individual systemic conditions. Discussion: The oral manifestations observed in these cases, such as ulceration and epithelial desquamation, are characteristic of advanced leprosy. Early diagnosis through recognition of oral symptoms is critical in preventing irreversible physical and social consequences. Dentists can play a key role in identifying leprosy, particularly when examining patients in endemic regions. Conclusion: Oral manifestations of leprosy provide an important diagnostic tool for early detection, potentially preventing severe complications, including physical disability and the associated socio-economic challenges. Dentists should be aware of these symptoms to help improve treatment outcomes and patient quality of life.References
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24. Santos, R.G., Nunes, B.V., Domiciano, G.S., Santos, H.G., Silva, J.C., Martins, M.D., Delfino, P.H., & Mesquita Júnior, F. (2021). Leprosy: a view of the molecular interaction of Mycobacterium leprae with Schwann Cells. São Paulo Medical Journal.
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27. Dewi, D.A., Djatmiko, C.B., Rachmawati, I., Arkania, N., Wiliantari, N.M., & Nadhira, F. (2023). Immunopathogenesis of Type 1 and Type 2 Leprosy Reaction: An Update Review. Cureus, 15.
28. Luo, Y., Kiriya, M., Tanigawa, K., Kawashima, A., Nakamura, Y., Ishii, N., & Suzuki, K. (2021). Host-related laboratory parameters for leprosy reactions. Frontiers in Medicine, 8, 694376.
29. Jha, A.K., Zeeshan, M., Tiwary, P.K., Singh, A., Roy, P.K., & Chaudhary, R.K. (2020). Dermoscopy of Type 1 Lepra Reaction in Skin of Color. Dermatology Practical & Conceptual, 10.
30. Mas Rusyati, L.M., Hatta, M., Widiana, I.G., Adiguna, M.S., Wardana, M., Dwiyanti, R., Noviyanti, R.A., Sabir, M.M., Yasir, Y., Paramita, S., Junita, A.R., & Primaguna, M.R. (2020). Higher Treg FoxP3 and TGF-β mRNA Expression in Type 2 Reaction ENL (Erythema Nodosum Leprosum) Patients in Mycobacterium leprae Infection. The Open Microbiology Journal.
31. Abril-Pérez, C., Palacios-Diaz, R.D., Navarro-Mira, M.Á., & Botella-Estrada, R. (2021). Successful treatment of erythema nodosum leprosum with apremilast. Dermatologic Therapy, 35.
2. Idris, F., & Mellaratna, W. P. (2023). Morbus Hansen (Kusta). GALENICAL: Jurnal Kedokteran dan Kesehatan Mahasiswa Malikussaleh, 2(6), 11-23.
3. Widasmara, D., Basuki, S., Florensia, D., Setyagraha, A., & Prasetyorini, N. (2020). Efektivitas multi drug therapy pada transmisi morbus hansen transplasental. Intisari Sains Medis, 11(2), 425-428.
4. Aviana, F., Birawan, I. M., & Sutrini, N. N. A. (2022). Profil Penderita Morbus Hansen di Poliklinik Kulit dan Kelamin RSUD Bali Mandara Januari 2018-Desember 2020. Cermin Dunia Kedokteran, 49(2), 66-68.
5. Hambridge, T., Nanjan Chandran, S. L., Geluk, A., Saunderson, P., & Richardus, J. H. (2021). Mycobacterium leprae transmission characteristics during the declining stages of leprosy incidence: a systematic review. PLoS neglected tropical diseases, 15(5), e0009436.
6. Andrew, K., & Kadala, M. (2020). Leprosy: A Review of History, Clinical Presentation and Treatments. American Journal of Infectious Diseases, 8(3), 88-94.
7. Le, P. H., Philippeaux, S., Mccollins, T., Besong, C., Kellar, A., Klapper, V. G., & Kaye, A. D. (2023). Pathogenesis, clinical considerations, and treatments: A narrative review on leprosy. Cureus, 15(12).
8. Bento, L. F. D. A., Brandão, D. G., Ferreira, K. D. M., Santana, S. F., Silva, L. K. D. O., Dos Santos, E. G. F., & Neto, J. D. A. L. (2020). Leprosy Lesions in Oral Cavity: A Review Of The Literature On Aspects Relevant To The Dentist. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 130(3), e284.
9. Singh, M., Sawhney, H., Mishra, R., & Kumar, J. (2022). An overview of leprosy with its oral manifestations: A comprehensive review. SRM Journal of Research in Dental Sciences, 13(4), 185-189.
10. Ferreira, I. S., & Ribeiro, A. Z. L. (2021). Prejuízos do Diagnóstico Tardio em Hanseníase: Uma Revisão Integrativa. Revista de Patologia do Tocantins, 8(2), 65-69.
11. Makhakhe, L. (2021). Leprosy review. South African Family Practice, 63(4).
12. Gilmore, A., Roller, J., & Dyer, J. A. (2023). Leprosy (Hansen’s disease): an update and review. Missouri Medicine, 120(1), 39.
13. Bhandari, J., Awais, M., & Gupta, V. (2020). Leprosy (Hansen Disease). StatPearls [Internet].
14. Margoles, L., del Rio, C., & Franco-Paredes, C. (2011). Leprosy: a modern assessment of an ancient neglected disease. Boletín Médico del Hospital Infantil de México, 68(2), 110-116.
15. Borah Slater, K. (2023). A Current Perspective on Leprosy (Hansen’s Disease). In Vaccines for Neglected Pathogens: Strategies, Achievements and Challenges: Focus on Leprosy, Leishmaniasis, Melioidosis and Tuberculosis (pp. 29-46). Cham: Springer International Publishing.
16. Vohra, P. (2022). Oral and systemic manifestations in leprosy a hospital based study with literature review. Indian Journal of Dermatology, 67(6), 631-638.
17. Vohra, P., Rahman, M. S. U., Subhada, B., Tiwari, R. V. C., Althaf, M. N., & Gahlawat, M. (2019). Oral manifestation in leprosy: a cross-sectional study of 100 cases with literature review. Journal of Family Medicine and Primary Care, 8(11), 3689-3694.
18. Mezaiko, E., Silva, L. R., Prudente, T. P., de Freitas Silva, B. S., & Silva, F. P. Y. (2023). Prevalence of oral manifestations of leprosy: a systematic review and meta-analysis. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.
19. Ebenezer, G. J., & Scollard, D. M. (2021). Treatment and evaluation advances in leprosy neuropathy. Neurotherapeutics, 18(4), 2337-2350.
20. Thirugnanasambandan TS, Latha S, Kumar MS. Clinical and Pathological Evaluation of Oral. Indian J Multidiscip Dent. 2011;1(2):105–9
21. Castellano, G. M., Villarroel-Dorrego, M., & Lessmann, L. C. (2020). Characteristics of oral lesions in patients with hansen disease. Actas Dermo-Sifiliográficas (English Edition), 111(8), 671-677.
22. Scheepers A. Correlation of Oral Surface Temperatures and the Lesions of Leprosy ’. Int JournaI Lepr. 1970;66(2):214–7.
23. Brügger, L.M., dos Santos, M.M., Lara, F.A., & Mietto, B.D. (2023). What happens when Schwann cells are exposed to Mycobacterium leprae – A systematic review. IBRO Neuroscience Reports, 15, 11 - 16.
24. Santos, R.G., Nunes, B.V., Domiciano, G.S., Santos, H.G., Silva, J.C., Martins, M.D., Delfino, P.H., & Mesquita Júnior, F. (2021). Leprosy: a view of the molecular interaction of Mycobacterium leprae with Schwann Cells. São Paulo Medical Journal.
25. Yasmin, H., Varghese, P.M., Bhakta, S., & Kishore, U. (2021). Pathogenesis and Host Immune Response in Leprosy. Advances in experimental medicine and biology, 1313, 155-177 .
26. Marçal, P.H., Gama, R.S., Pereira de Oliveira, L.B., Martins-Filho, O.A., Pinheiro, R.O., Sarno, E.N., Moraes, M.O., & de Oliveira Fraga, L.A. (2020). Functional biomarker signatures of circulating T-cells and its association with distinct clinical status of leprosy patients and their respective household contacts. Infectious Diseases of Poverty, 9.
27. Dewi, D.A., Djatmiko, C.B., Rachmawati, I., Arkania, N., Wiliantari, N.M., & Nadhira, F. (2023). Immunopathogenesis of Type 1 and Type 2 Leprosy Reaction: An Update Review. Cureus, 15.
28. Luo, Y., Kiriya, M., Tanigawa, K., Kawashima, A., Nakamura, Y., Ishii, N., & Suzuki, K. (2021). Host-related laboratory parameters for leprosy reactions. Frontiers in Medicine, 8, 694376.
29. Jha, A.K., Zeeshan, M., Tiwary, P.K., Singh, A., Roy, P.K., & Chaudhary, R.K. (2020). Dermoscopy of Type 1 Lepra Reaction in Skin of Color. Dermatology Practical & Conceptual, 10.
30. Mas Rusyati, L.M., Hatta, M., Widiana, I.G., Adiguna, M.S., Wardana, M., Dwiyanti, R., Noviyanti, R.A., Sabir, M.M., Yasir, Y., Paramita, S., Junita, A.R., & Primaguna, M.R. (2020). Higher Treg FoxP3 and TGF-β mRNA Expression in Type 2 Reaction ENL (Erythema Nodosum Leprosum) Patients in Mycobacterium leprae Infection. The Open Microbiology Journal.
31. Abril-Pérez, C., Palacios-Diaz, R.D., Navarro-Mira, M.Á., & Botella-Estrada, R. (2021). Successful treatment of erythema nodosum leprosum with apremilast. Dermatologic Therapy, 35.
Published
2024-12-23
How to Cite
NURFIANTI, Nurfianti.
The Forgotten Infection Cases: Leprosy Disease Oral Manifestations and Its Problem.
Journal of Indonesian Dental Association, [S.l.], v. 7, n. 2, p. 35-42, dec. 2024.
ISSN 2621-6175.
Available at: <http://jurnal.pdgi.or.id/index.php/jida/article/view/1279>. Date accessed: 26 dec. 2024.
doi: https://doi.org/10.32793/jida.v7i2.1279.
Section
Case Report
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.