ABSTRACT
Leprosy, also known as Hansen's disease, is an age-old chronic granulomatous infection characterized by prominent cutaneous and neurologic findings. Long known to be caused by Mycobacterium leprae, a new etiologic species was identified and linked in 2008, Mycobacterium lepromatosis. The BCG vaccine with highly variable efficacy may soon be replaced by the first leprosy-specific subunit vaccine LepVax, which has recently moved forward in human trials. Recent evidence supporting theories of zoonotic transmission from armadillos and the less-discussed Eurasian red squirrels has emerged. Knowledge on genetic polymorphisms that may increase leprosy susceptibility, such as the newly uncovered mitochondrial ribosomal protein S5 (MRPS5) polymorphism in the Chinese population, has provided a fresh perspective and direction. Further, we will delineate the latest information on leprosy, including the possible effects of leprosy coinfection with COVID-19, HIV, and HTLV-1, and the shift to newer leprosy therapies and treatment regimens.
Subject(s)
COVID-19 , Leprosy , Animals , Armadillos/microbiology , Asian People , Humans , Leprosy/epidemiology , Leprosy/microbiology , Mycobacterium leprae/geneticsABSTRACT
Nevus depigmentosus (ND), also known as nevus achromicus or achromic nevus, is an uncommon congenital hypomelanosis of the skin that is often characterized as being nonprogressive and having serrated borders. It needs to be distinguished from other hypopigmented skin conditions such as nevus anemicus, hypomelanosis of Ito, Fitzpatrick patches (ash leaf spots) of tuberous sclerosis, vitiligo, indeterminate leprosy, and pigment demarcation lines. Treatment may be desired for aesthetic and possible psychosocial considerations. We review and update knowledge about ND and its simulants.
Subject(s)
Hypopigmentation/diagnosis , Nevus/diagnosis , Diagnosis, Differential , Esthetics , Humans , Hypopigmentation/epidemiology , Hypopigmentation/psychology , Hypopigmentation/therapy , Leprosy/diagnosis , Low-Level Light Therapy , Melanocytes/pathology , Melanocytes/transplantation , Nevus/epidemiology , Nevus/psychology , Nevus/therapy , PUVA Therapy , Risk Factors , Tuberous Sclerosis/diagnosisSubject(s)
Dermoscopy/methods , Ear Auricle/pathology , Melanoma/diagnosis , Mouth Mucosa/pathology , Adult , Female , Humans , Male , Melanoma/therapyABSTRACT
Vitiligo reflects a systemic process that has important implications beyond the skin. These include other autoimmune diseases and ocular and neurological abnormalities. Alezzandrini syndrome and Vogt-Koyanagi-Harada syndrome particularly exemplify this relationship. In addition, vitiligo may be confused with other systemic disorders, including tuberous sclerosis, progressive systemic sclerosis (scleroderma), melanoma, and, in endemic regions, leprosy. We describe these associations and emphasize the importance of depigmenting disorders.
Subject(s)
Vitiligo/etiology , Autoimmune Diseases/complications , Autoimmune Diseases/diagnosis , Humans , Pigmentation Disorders/diagnosis , Tuberous Sclerosis/complications , Tuberous Sclerosis/diagnosis , Waardenburg Syndrome/complications , Waardenburg Syndrome/diagnosisABSTRACT
Arsenic is an odorless, colorless and tasteless element long linked with effects on the skin and viscera. Exposure to it may be cryptic. Although human intake can occur from four forms, elemental, inorganic (trivalent and pentavalent arsenic) and organic arsenic, the trivalent inorganic arsenicals constitute the major human hazard. Arsenic usually reaches the skin from occupational, therapeutic, or environmental exposure, although it still may be employed as a poison. Occupations involving new technologies are not exempt from arsenic exposure. Its acute and chronic effects are noteworthy. Treatment options exist for arsenic-induced pathology, but prevention of toxicity remains the main focus. Vitamin and mineral supplementation may play a role in the treatment of arsenic toxicity.