Senol M, Ozcan A, Aydin A, Karincaoglu Y, Sasmaz S, Sener S
Department of Dermatology, Inönü University School of Medicine, Malatya, Turkey.
Pediatr Dermatol. 2000 Mar-Apr;17(2):133-5. doi: 10.1046/j.1525-1470.2000.01730.x.
The incidence of tuberculosis and extrapulmonary forms of this disease is increasing all over the world. Lupus vulgaris is the most prevalent form of cutaneous tuberculosis in Europe and the Middle East. Papulonecrotic tuberculid, the most common form of hyperergic response to mycobacteria or their fragments, is uncommon in children. We report lupus vulgaris with papulonecrotic tuberculid in a 12-year-old girl who had a 3-year history of slowly growing plaques on her trunk, extremities, and the tip of her nose and papuloulcerative lesions over her entire body. A skin biopsy specimen showed minimally caseating granulomatous inflammation. Staining for acid-fast bacilli was negative in both plaques and papules. Polymerase chain reaction identified Mycobacterium tuberculosis DNA in the patient's sputum, gastric fluid, and plaques and was negative in the papules. She was started on antituberculous therapy with four drugs and her lesions responded rapidly.
全球范围内，结核病及其肺外形式的发病率都在上升。寻常狼疮是欧洲和中东地区最常见的皮肤结核形式。丘疹坏死性结核疹是对分枝杆菌或其碎片最常见的超敏反应形式，在儿童中并不常见。我们报告了一名12岁女孩，她患有寻常狼疮合并丘疹坏死性结核疹，其躯干、四肢和鼻尖有3年缓慢生长的斑块病史，全身还有丘疹溃疡性病变。皮肤活检标本显示有轻微干酪样肉芽肿性炎症。斑块和丘疹的抗酸杆菌染色均为阴性。聚合酶链反应在患者的痰液、胃液和斑块中检测到结核分枝杆菌DNA，而在丘疹中为阴性。她开始接受四种药物的抗结核治疗，病变迅速好转。
