Cutaneous Tuberculosis
Cutaneous Tuberculosis
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DOI：
10.1007/978-3-030-04744-3_13
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发表时间：
2019-03
期刊：
影响因子：
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通讯作者：
Yanqing Chen
中科院分区：
文献类型：
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作者：
Yanqing Chen
结核病是一种由结核分枝杆菌引起的感染，已经存在了数千年，直到今天它仍然是一个主要的全球公共卫生问题，仅在2015年就估计有1040万新病例。全球大部分疾病是肺结核，但杆菌可以以肺外结核的形式影响任何其他身体器官，包括皮肤，约占8.4- 13.7%。这使得皮肤结核成为一种相对罕见的传染病，仅占肺外结核病例的1-2%，约占所有皮肤疾病的0.1-1%。皮肤结核病的增加伴随着艾滋病毒感染、耐多药结核病的增加以及最近生物制剂特别是抗肿瘤坏死因子（抗TNF）的治疗使用的增加。临床表现主要取决于感染途径、细胞免疫和感染微生物的毒力。皮肤结核病分为三大类：外源性接种、内源性感染和血行播散。非典型分枝杆菌感染主要发生在免疫功能低下的宿主中。在免疫功能正常的宿主中，感染发生在皮肤穿透之后，通常是局部的，而在免疫功能低下的患者中有传播的趋势。目前皮肤结核病的治疗选择仅限于常规抗结核药物，以及某些适应症的一些手术干预（手术切除病变和矫正畸形）。
Tuberculosis, an infection caused byMycobacterium tuberculosisbacilli, has existed for millennia, and till today it continues to be a major global public health concern, and in 2015 alone there were estimated 10.4 million new cases. The bulk of the disease globally is pulmonary TB, but the bacilli can affect any other body organ including the skin in the form of extrapulmonary TB in about 8.4–13.7%. This makes tuberculosis of the skin a relatively uncommon infectious disease comprising only 1–2% of the extrapulmonary tuberculosis cases and approximately 0.1–1% of all cutaneous disorders. Cutaneous TB increases with concomitant infection with HIV, an increase in multidrug-resistant TB and the recent rise in the therapeutic use of biologics specifically antitumor necrosis factor (anti-TNF). The clinical presentation depends mainly on the route of infection, cellular immunity, and virulence of the infecting organism. Cutaneous TB is classified into three main categories: exogenous inoculation, endogenous infection, and hematogenous spread.Infections with atypical mycobacteria occur predominantly in immunocompromised hosts. In immunocompetent hosts, infection follows skin penetration and is usually localized, while there is a tendency for dissemination in immunocompromised patients. The current therapeutic options for cutaneous TB are limited to the conventional anti-TB drugs in addition to some surgical interventions in certain indications (surgical excision of lesions and correction of deformities).