Detection of Mycobacterium tuberculosis DNA in lobular granulomatous panniculitis (Erythema induratum nodular vasculitis)
Detection of Mycobacterium tuberculosis DNA in lobular granulomatous panniculitis (Erythema induratum nodular vasculitis)
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DOI：
10.1001/archderm.133.4.457
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发表时间：
1997-04-01
影响因子：
--
通讯作者：
deMoragas, J
中科院分区：
文献类型：
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作者：
Baselga, E;Margall, N;deMoragas, J
目的：应用聚合酶链反应（PCR）扩增技术，确定小叶性肉芽肿性潘膜炎皮肤活检标本中是否存在结核分枝杆菌复合体DNA。设计：回顾性描述性研究。环境：大学附属医院。患者：从纳入研究的65例患者中，我们检查了72例石蜡包埋皮肤活检标本，组织学诊断为硬化性红斑或结节性血管炎。活检标本来自1976年至1994年西班牙巴塞罗那Santa Creu i Sant Pau医院皮肤科和病理学部门的组织病理学档案。22个活检标本被排除在最终分析之外，因为我们无法放大内部控制。主要观察指标：检测结核分枝杆菌复合体特异性IS6110插入序列的123个碱基对片段。结果：77%皮肤活检标本结核分枝杆菌复合体DNA PCR扩增阳性。患者的年龄、结节的溃疡程度、对纯化蛋白衍生物的反应性、胸部x线检查异常结果、个人和家族结核病史、PCR结果均无显著差异。pcr阳性组组织学检查坏死灶的存在程度和程度明显高于对照组（P= 0.04）。以下变量均与PCR结果无关：血管炎的存在、肉芽肿浸润的程度、巨细胞的数量和组织良好的肉芽肿的存在。结论：在相当数量的小叶性肉芽肿性全身炎皮肤活检标本中可检出结核分枝杆菌的DNA。评估的临床和组织学变量均不能准确预测PCR扩增结果。
Objective: To determine, using polymerase chain reaction (PCR) amplification, if Mycobacterium tuberculosis complex DNA is present in the skin biopsy specimens of lobular granulomatous panniculitis.Design: A retrospective descriptive study.Setting: A university-based hospital.Patients: From the 65 patients included in the study, we examined 72 paraffin-embedded skin biopsy specimens with a histologic diagnosis of erythema induratum or nodular vasculitis. The biopsy specimens were from the histopathological archives of the Departments of Dermatology and Pathology of the Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, from 1976 to 1994. Twenty-two biopsy specimens were excluded from the final analysis because we could not amplify the internal control.Main Outcome Measures: Detection of a 123-base pair fragment of the IS6110 insertion sequence specific for M tuberculosis complex.Results: The results of PCR amplification were positive for M tuberculosis complex DNA in 77% of the skin biopsy specimens. No significant difference could be detected with respect to the age of the patients, ulceration of the nodules, reactivity to purified protein derivative, abnormal results of a chest x-ray examination, personal and family history of tuberculosis, and PCR results. The presence and degree of necrosis on histologic examination were significantly higher in the PCR-positive group (P=.04). None of the following variables were associated with PCR results: presence of vasculitis, degree of granulomatous infiltrates, number of giant cells, and presence of well-organized granulomas.Conclusions: The DNA of M tuberculosis can be detected in a considerable number of skin biopsy specimens of lobular granulomatous panniculitis. None of the clinical and histologic variables evaluated could accurately predict the results of PCR amplification.