Cutaneous tuberculosis: A diagnostic and therapeutic study of 20 cases
Cutaneous tuberculosis: A diagnostic and therapeutic study of 20 cases
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皮肤结核20例诊治分析
DOI：
10.3109/09546634.2010.487889
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发表时间：
2011-12-01
影响因子：
2.9
通讯作者：
Cui, Pangen
中科院分区：
文献类型：
--
作者：
Wang, Hongsheng;Wu, Qinxue;Cui, Pangen
皮肤结核病正在死灰复燃。它仍然是皮肤科实践中最难诊断和最难诊断的疾病之一。我们试图描述皮肤结核病例的临床表现、实验室特征和抗结核治疗。本文对20例皮肤结核进行了观察。在20例病例中，7例为女性（35%），13例为男性（65%）。有8例（40%）寻常狼疮，4例（20%）泌尿系统结核，4例（20%）疣状皮肤结核，2例（10%）硬皮病，2例（10%）初次接种结核。通过在37 ℃的Lowenstein-Jensen培养基中培养，总共分离出20株抗酸杆菌。聚合酶链反应（PCR）鉴定结果表明，所有菌株均为结核分枝杆菌。采用绝对浓度法进行体外药敏试验，结果表明20株菌对利福平、乙胺丁醇、异烟肼敏感，2株对链霉素耐药。所有患者对抗结核治疗反应良好。皮肤结核是一种在中国大陆仍应受到重视的皮肤病，在本研究中，寻常狼疮是最常见的临床表现。
Cutaneous tuberculosis is showing a resurgence. It continues to be one of the most elusive and difficult diseases to diagnose in dermatological practice. We sought to describe the clinical manifestations, laboratory features, and antituberculous therapy in cases of cutaneous tuberculosis. Twenty cases of cutaneous tuberculosis were observed in this study. Of the 20 cases, seven were in women (35%) and 13 were in men (65%). There were eight (40%) cases of lupus vulgaris, four (20%) cases of orificial tuberculosis, four (20%) cases of tuberculosis verrucosa cutis, two (10%) cases of scrofuloderma, and two (10%) cases of primary inoculation tuberculosis. In total, 20 strains of acid-fast bacilli were isolated by culture in Lowenstein-Jensen medium at 37 degrees C. Mycobacterial species identification by polymerase chain reaction (PCR) assay showed that all strains were Mycobacterium tuberculosis. In vitro susceptibility testing by use of absolute concentration method showed that the 20 strains were sensitive to rifampin, ethambutol, and isoniazid; however, two strains were resistant to streptomycin. All of the patients responded favourably to antituberculous treatment. Cutaneous tuberculosis is a skin disease that should still be thought much of in mainland China, and in this study lupus vulgaris is the most common clinical presentation.