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Functional Impairment of Skin Appendages Due to Peripheral Nerve Involvement by Mycobacterium leprae.

Abstract

In the earliest stage of infection, bacteria parasitize fine fiber twigs of autonomic peripheral nerves supplying efferent impulses to appendages of the skin. This obligate intracellular pathogen invades Schwann cells, the glial cells of peripheral nerves. Intracellular events inhibit Schwann cell physiology in complex ways, which include demyelination and dedifferentiation. Ultimately, axons embraced by their surrounding dysfunctional glia are damaged by poorly understood mechanisms. Loss of nerve conduction impairs the functions of skin appendages including hair growth, sebaceous gland secretion, sweating, and skin pigmentation. At the clinical level, these changes may be subtle and may precede the more obvious anesthetic skin lesions associated with Hansen's disease. Recognizing the early signs of skin appendage malfunction may aid in diagnosis leading to initiation of antimycobacterial treatment. Effective therapy administered early during infection may prevent irreversible peripheral nerve destruction, the presage for morbid complications of leprosy.

More information

Type
Journal Article
Author
Granger D
Rosado-Santos H
Lo T
Florell S
Shimwella R
Year of Publication
2020
Journal
Open forum infectious diseases
Volume
7
Issue
10
Number of Pages
ofaa419
Date Published
10/2020
Language
eng
ISSN Number
2328-8957
DOI
10.1093/ofid/ofaa419
Alternate Journal
Open Forum Infect Dis
PMID
33094119
Publication Language
eng