The nose in lepromatous leprosy; bacteriological and histopathological studies of patients treated with dapsone monotherapy for varying periods of time.
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.
D003622:Dapsone / Q000627:therapeutic use*; D006801:Humans; D007918:Leprosy / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D009297:Nasal Mucosa / Q000378:metabolism; D009666:Nose / Q000473:pathology*; D013997:Time Factors
D003622:Dapsone