CLINICAL AND IMMUNOHISTOPATHOLOGICAL STUDY OF ORAL LESIONS OF LEPROSY

Objective. To compare clinical and immunohistopathological features of oral lesions with clinically normal oral mucosa from patients with leprosy. Study design. This is a cross-sectional study of patients with leprosy showing specific oral lesions selected from January 2000 to June 2018. Patients with leprosy who did not have oral lesions and agreed to oral biopsy were included in the comparisons of analysis, which consisted of clinical and immunohistopathological (anti-PGL1 and MLSA expression) study. Results. A total of 416 patients with leprosy were evaluated and patients with leprosy-specific oral lesions (n = 14) were included. All were men, and the majority had the lepromatous form. The oral mucosa showed acanthosis, lymphocyte exocytosis, foamy macrophages, and nonfragmented bacilli. Patients without oral lesions (n = 14) mostly had the multibacillary (MB) form, and the oral mucosa showed minimal inflammatory infiltrates and no foamy macrophages in most of the samples. PGL1 and MLSA were detected in all oral lesions and in 6 specimens from clinically normal mucosa. Conclusions. The oral cavity may be affected by leprosy in advanced stages of the MB form. Histopathological findings of oral lesions seem similar to cutaneous lesions, and anti-PGL1 and MLSA are effective markers to determine Mycobacterium leprae presence either in oral lesions or clinically normal mucosa of patients with the MB form of leprosy.