02070nas a2200277   4500000000100000008004100001260001300042653002700055653001100082653002300093653001200116653001000128653001700138653003000155653000900185100001100194700001600205700001400221700001300235245011900248856005000367300001100417490000700428520134300435022001401778       2008                            d  c2008 Mar10aFamily Characteristics10aHumans10aLeprostatic Agents10aleprosy10aMucus10aNasal Mucosa10apolymerase chain reaction10aSkin1 aJob CK1 aJayakumar J1 aKearney M1 aGillis T00aTransmission of leprosy: a study of skin and nasal secretions of household contacts of leprosy patients using PCR.  uhttp://www.ajtmh.org/cgi/reprint/78/3/518.pdf  a518-210 v783 a<p>It is generally held that dissemination of Mycobacterium leprae is from nasal mucosa and not through the skin of infected patients. In this study, we evaluated M. leprae in the unbroken skin and nasal secretions of multibacillary (MB) leprosy patients and their contacts. Specimens were examined by direct microscopy and polymerase chain reaction (PCR) for M. leprae DNA. Results showed that 60% of untreated MB leprosy patients examined histologically had acid-fast bacilli in the keratin layer. By PCR studies it was found that 80% of the patients had M. leprae DNA in skin washings and 60% had M. leprae DNA on swabs obtained from the nasal mucosa. Ninety-three contacts of the untreated MB cases were also tested for exposure to M. leprae by analyzing skin washings and nasal secretions by PCR. PCR analysis showed significant skin (17% positive) and nasal muscosal (4%) exposure in contacts before instituting treatment of the index cases. After 2 months of treating the index cases, all contacts tested were negative for M. leprae DNA. These data suggested that both skin and nasal epithelia of untreated MB leprosy patients contribute to the shedding of M. leprae into the environment and contacts of untreated MB cases are at risk for contact with M. leprae through both the nasal mucosa and exposed surfaces of their skin.</p>  a0002-9637