
Contents
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Direct Effects of M. Leprae Direct Effects of M. Leprae
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Absorption, Remodeling, and Possible Total Loss of the Anterior Nasal Column Absorption, Remodeling, and Possible Total Loss of the Anterior Nasal Column
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Absorption, Recession, and Remodeling of the Alveolar Process of the Maxilla Absorption, Recession, and Remodeling of the Alveolar Process of the Maxilla
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Inflammatory Changes to the Palatine Process of the Maxilla: Nasal Surface Inflammatory Changes to the Palatine Process of the Maxilla: Nasal Surface
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Inflammatory Changes to the Palatine Process of the Maxilla: Oral Surface Inflammatory Changes to the Palatine Process of the Maxilla: Oral Surface
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Grading the Bone Changes of the Alveolar Process of the Maxilla, the Anterior Nasal Spine, and the Palatine Process of the Maxilla Grading the Bone Changes of the Alveolar Process of the Maxilla, the Anterior Nasal Spine, and the Palatine Process of the Maxilla
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Differential Diagnoses for Rhinomaxillary Syndrome Differential Diagnoses for Rhinomaxillary Syndrome
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Rhinomaxillary Syndrome and Other Associated Skeletal Changes Rhinomaxillary Syndrome and Other Associated Skeletal Changes
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Indirect Effects of M. Leprae: The Peripheral Nerves Indirect Effects of M. Leprae: The Peripheral Nerves
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Sensory Nerve Involvement Sensory Nerve Involvement
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The Hands The Hands
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The Feet The Feet
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Septic Bone Change in Leprosy Septic Bone Change in Leprosy
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Differential Diagnosis of Bone Changes Due to Damage to the Sensory Nerves Differential Diagnosis of Bone Changes Due to Damage to the Sensory Nerves
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Motor Nerve Involvement Motor Nerve Involvement
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Differential Diagnosis of Bone Changes Due to Damage to the Motor Nerves Differential Diagnosis of Bone Changes Due to Damage to the Motor Nerves
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Autonomic Neuropathy Autonomic Neuropathy
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Differential Diagnosis of Autonomic Nerve Bone Changes Differential Diagnosis of Autonomic Nerve Bone Changes
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The Relative Frequency of Foot and Hand Bone Alterations in Leprosy: Past and Present The Relative Frequency of Foot and Hand Bone Alterations in Leprosy: Past and Present
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Other Associated Bone Changes Other Associated Bone Changes
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Osteopenia and Osteoporosis Osteopenia and Osteoporosis
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Periosteal Lesions on the Long and Short Tubular Bones Periosteal Lesions on the Long and Short Tubular Bones
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Porosity of the Orbits Porosity of the Orbits
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Respiratory Involvement Respiratory Involvement
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Less Commonly Noted Bone Changes Less Commonly Noted Bone Changes
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The Senses and Leprosy The Senses and Leprosy
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Diagnosis of Leprosy in Skeletal Remains: What Features Should be Present? Diagnosis of Leprosy in Skeletal Remains: What Features Should be Present?
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Beyond the Macroscopic: Other Bioarchaeological Methods for Diagnosing Leprosy Beyond the Macroscopic: Other Bioarchaeological Methods for Diagnosing Leprosy
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Analysis of Ancient DNA and Mycolic Acids Analysis of Ancient DNA and Mycolic Acids
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Microscopy Microscopy
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Imaging Imaging
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Confounding Factors that Affect Diagnosis of Skeletal Leprosy Confounding Factors that Affect Diagnosis of Skeletal Leprosy
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Conclusions Conclusions
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4 The Bioarchaeology of Leprosy
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Published:October 2020
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Abstract
This chapter explores the bone changes in the skeleton related to leprosy (paleopathology). Diagnosing leprosy in skeletons ideally requires a complete well-preserved skeleton. The facial, hand, and foot bones are affected, but only a few percent of untreated people will develop bone lesions, and the type of leprosy depends on the resistance of their immune system to M. leprae. Most skeletons diagnosed will display lesions due to the low-resistant form: lepromatous leprosy. Damage to the peripheral nerves by M. leprae is responsible for the alterations to the hand and foot bones. The bone changes of the skull represent the direct effects of M. leprae being inhaled into the mouth and nose. Beyond visual/macroscopic analysis, imaging and microscopy have been used for diagnosis. Biomolecular analysis is the main advance in analytical methods (mainly focusing on ancient DNA). Sequencing of the modern M. leprae and M. lepromatosis genomes have provided data for comparative analyses and testable hypotheses regarding the origin, evolution, and history of leprosy. These data are enabling paleogeneticists, historians, and bioarchaeologists to re-evaluate the long history of leprosy in relation to historical accounts of the drivers for the migration of people with leprosy across the globe.
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