{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:34:06Z","timestamp":1773038046909,"version":"3.50.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,9,13]],"date-time":"2020-09-13T00:00:00Z","timestamp":1599955200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"International Health Program"},{"name":"Department of Medicine, Duke University School of Medicine"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In the earliest stage of Mycobacterium leprae 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\u2019s 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.<\/jats:p>","DOI":"10.1093\/ofid\/ofaa419","type":"journal-article","created":{"date-parts":[[2020,9,13]],"date-time":"2020-09-13T08:24:08Z","timestamp":1599985448000},"source":"Crossref","is-referenced-by-count":2,"title":["Functional Impairment of Skin Appendages Due to Peripheral Nerve Involvement by Mycobacterium leprae"],"prefix":"10.1093","volume":"7","author":[{"given":"Donald L","family":"Granger","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA"},{"name":"Veterans Affairs Medical Center, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Rosado-Santos","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tze Shien","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA"},{"name":"Veterans Affairs Medical Center, Fargo, North Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott R","family":"Florell","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rehema A T","family":"Shimwella","sequence":"additional","affiliation":[{"name":"Leprology-Venereology Service, Muhimbili National Hospital, Dar es Salaam, United Republic of 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