01862nas a2200253   4500000000100000008004100001260001300042653000900055653001100064653001200075653001100087653001100098653001600109100001900125700001200144700001400156700001200170245013800182856005900320300001100379490000700390520119700397022001401594       1990                            d  c1990 Sep10aMale10aMalawi10aleprosy10aHumans10aFemale10aAge Factors1 aPonnighaus J M1 aFine PE1 aGruer P J1 aMaine N00aThe anatomical distribution of single leprosy lesions in an African population, and its implications for the pathogenesis of leprosy.  uhttp://leprev.ilsl.br/pdfs/1990/v61n3/pdf/v61n3a06.pdf  a242-500 v613 a<p>Data on the anatomical sites of single leprosy lesions found in 635 newly diagnosed and biopsy-confirmed leprosy patients are presented. These patients were found during total population surveys carried out by the Lepra Evaluation Project, a prospective longitudinal study of the epidemiology of leprosy in Karonga District, Northern Malaŵi. There was a striking excess of single lesions on the face and the back of the arms, compared to the distribution of skin surface area, and a deficit on the legs, regardless of age. There is some evidence for a sex difference in lesion distribution among adults, with facial and arm lesions being relatively more common in females and back lesions being more common in males. The excess of lesions on the face compared to the lower limbs is similar to data from Uganda, but very unlike data from Burma and elsewhere in Asia. Overall, the distribution of lesions does not suggest a pattern reflecting entry of Mycobacterium leprae, nor does it suggest an association with anatomical distribution of the nervous or vascular system. It is argued that the distribution reflects the influence of some 'local' environmental or behavioural factors.</p>
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