02341nas a2200313   4500000000100000008004100001260001300042653001100055653001700066653001100083653002600094653002600120653002600146653002600172653002200198653001100220653001000231653001200241653002500253653001700278653001700295100001700312700001700329245005700346300001100403490000700414520159200421022001402013       1999                            d  c1999 Apr10aEurope10aFacial Bones10aFacies10aHistory, 15th Century10aHistory, 16th Century10aHistory, 17th Century10aHistory, 19th Century10aHistory, Medieval10aHumans10aJapan10aleprosy10aMedicine in the Arts10aMouth Mucosa10aNasal Mucosa1 aScollard D M1 aSkinsnes O K00aOropharyngeal leprosy in art, history, and medicine.  a463-700 v873 a<p>Advanced lesions of the face, nasopharynx, and oropharynx have played an important role in the medical and social history of Hansen's disease. Renaissance artists included detailed portrayals of these lesions in some of their paintings, a testimony not only to their artistic skill and powers of observation but also to the common presence of these patients in European cities and towns of the period. The disease is now understood as a broad immunologic spectrum of host responses to Mycobacterium leprae, with a variety of clinical and pathologic manifestations in nerve, soft tissues, and bone. This review incorporates the findings of 2 extraordinary studies (one from Europe and the other from Japan) of pharyngeal and facial lesions. In the 1950s, studies of skeletal remains from the churchyard of a Danish leprosarium revealed a triad of maxillofacial lesions unique to leprosy and designated facies leprosa. In pre-World War II Japan, before effective treatment had been discovered, a prominent otorhinolaryngologist studying oropharyngeal and nasopharyngeal lesions prepared watercolor illustrations of the natural progression of untreated Hansen's disease. As a result of effective antimicrobial therapy, such advanced lesions are now rarely seen, but the presenting signs and symptoms of leprosy still occasionally arise in the nasal and oral mucosa. The nasopharynx and oropharynx may be important early sites of inoculation and infection by M leprae, and they require additional emphasis in worldwide efforts toward early diagnosis and treatment of Hansen's disease.</p>  a1079-2104