Cutaneous Mycobacterium massiliense infection: A sporadic case in Japan
Cutaneous Mycobacterium massiliense infection: A sporadic case in Japan
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皮肤马西分枝杆菌感染：日本的散发病例
DOI：
10.1111/j.1346-8138.2011.01339.x
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Kurato Osamura
中科院分区：
文献类型：
--
作者：
T. Otsuki;S. Izaki;K. Nakanaga;Y. Hoshino;N. Ishii;Kurato Osamura
表面不规则的梅毒营养性结节性病变被称为“Framboesiform”或“Raspberry-like”。这种覆盆子状的表面也被描述为有疣，并且也可能是潮湿的、结痂的或溃烂的。李等人。报道了一位与我们的患者临床上相似的梅毒患者，他们将其称为肿瘤性梅毒。我们认为，该患者的皮肤病变与梅毒的描述非常吻合。以往报道中，梅毒患者的面部、颈部、躯干、四肢和生殖器部位出现多发性梅毒病变。他们还表现出手掌、足底和生殖器上有额外的皮肤病变，或者有生殖器溃疡病史，并且/或者表现出淋巴结肿大，这些被认为是梅毒的临床特征。然而，我们的患者仅表现出头皮上的孤立性皮肤病变，没有其他皮肤病变或全身症状的存在和病史。因此，很难根据临床表现来考虑梅毒的可能性。为了预防三期梅毒的后遗症，必须对梅毒进行正确的诊断和适当的治疗。然而，如果梅毒患者皮肤病变异常，诊断往往会被延误，就像我们的病例一样。因此，我们建议，即使没有二期梅毒的其他皮肤表现和全身症状，也应将二期梅毒纳入结节性病变的鉴别诊断范围。
vegetative, nodular lesions of syphilis with an irregular surface have been referred to as framboesiform or raspberry-like. This raspberry-like surface also has been described as being warty, and may also be moist, crusted or ulcerated. Lee et al. reported a patient with clinically similar syphilid as our patient and they termed it tumorous syphilid. We believe that our patient’s skin lesion fits well with the description of framboesiform syphilid. In previous reports, patients with framboesiform syphilid showed multiple syphilid lesions on the face, neck, trunk, extremities and genital area. They also showed additional cutaneous lesions on the palm, sole and genitalia, or had a history of ulcer on the genitalia, and ⁄ or showed lymph node enlargement, which are considered as clinical features of syphilis. However, our patient showed only a solitary skin lesion on the scalp without the presence and history of other skin lesion or constitutional symptoms. Therefore, it was difficult to consider the possibility of syphilis based on the clinical findings. To prevent the sequelae of tertiary syphilis, correct diagnosis and proper treatment of syphilis are mandatory. However, in case of a syphilis patient with unusual skin lesions, the diagnosis is often delayed as our case. Therefore, we suggest that the secondary syphilis should be included in the differential diagnosis of nodular lesions, even in the absence of other cutaneous manifestations and constitutional symptoms of secondary syphilis.