Orofacial Manifestations of Leprosy Patients in Cameroon

Abstract

Leprosy is a chronic infectious disease with interpersonal transmission caused by Mycobacterium leprae, a microorganism that has an affinity for the skin and peripheral nerves. In more advanced stages, it affects internal organs and the mucous membranes, with a high potential for causing physical disability. The aim of the present study was to determine the frequency of orofacial manifestations in patients diagnosed with leprosy. A cross-sectional, descriptive study was carried out over a 6 month period from January to June 2020.  After explaining the study design to the patients, demographic information and a review on the evolution of leprosy were recorded in a structured questionnaire. An intraoral and extraoral examination was carried out to determine the orofacial leprous lesions. A total of 63 patients with leprosy, 39 (61.9%) males and 24 (38.1%) females with a mean age of 52.2±2.1 were examined. Two thirds 38 (60.3%) presented with the lepromatous variant, while 25 (39.7%) had the tuberculoid variant. Positive oral or facial lesions were seen in 41(65%) patients. Facial lesions were present in 29 (46.1%) half 20 (52.6%) in the lepromatous type and 9 (36.6%) in tuberculoid type. The predominant manifestations were loss of eyelashes or scanty eyebrows 11 (15.9%), followed by hypopigmented patches over facial skin 8 (12.7%) and ocular involvement 6 (9.5%). Oral lesions were present in 12 (19.1%) patients, with which 9 (23.6%) were lepromatous and three (12%) tuberculoid. Fissured tongue 6 (9.5%) and circumferential papillary hypoplasia 3 (4.8%) were more predominant. The mean DMFT and plaque index were 16.5 and 2.7 ± 1.2   respectively. Orofacial lesions are associated with leprosy infection with a low frequency. The present study found that dental caries and periodontal diseases were frequent and severe in this population. It is anticipated that the findings of the study will assist in initiating and creating periodic surveys and interventions in terms of awareness campaigns among the leprosy patients. The oral mucosa should be thoroughly examined in patients with leprosy, as the oral mucosa may be a secondary source of Mycobacterium leprae transmission and infection.