Mahaisavariya Punkae, Chaiprasert Angkana, Manonukul Jane, Khemngern Supakan
Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand.
Int J Dermatol. 2002 Jan;41(1):28-31. doi: 10.1046/j.1365-4362.2002.01362.x.
In recent years, the rare association of Sweet's syndrome with nontuberculous mycobacterial lymphadenitis has been reported.
To report the clinical, demographic, and bacteriologic data and association with Sweet's syndrome of 18 patients with scrofuloderma and scrofuloderma-like condition caused by nontuberculous mycobacterial infections seen during the past 7 years (1994-2000).
In all patients, a biopsy specimen was obtained for histopathologic and microbiologic studies. Patients from whom Mycobacterium tuberculosis and nontuberculous mycobacteria were isolated from the culture of skin biopsy specimens were included. Deep fungal infection was excluded by the lack of a fungal element in histologic section and cultural methods. The patients were treated with antimicrobials or antituberculous drugs according to the causative species.
Eighteen cases of scrofuloderma (nine male, nine female; mean age, 36.9 years) were found among 104 patients with cutaneous tuberculosis and nontuberculous mycobacterial cutaneous infections. Sixteen of the 18 cases had lymphadenitis as the underlying focus of scrofuloderma: 15 cases occurred in the cervical group and one case in the inguinal area. One case drained from the soft tissue and one from the paranasal air sinus. Five cases had multiple episodes of Sweet' s syndrome during the course of treatment. Most cases in this group (four of the five) were middle-aged women with cervical lymphadenitis, and the most common species were rapid growers.
Age, sex, and the site of infection may have some influence on the association with Sweet's syndrome in nontuberculous mycobacterial infections.
近年来，有报道称Sweet综合征与非结核分枝杆菌性淋巴结炎存在罕见关联。
报告过去7年（1994 - 2000年）期间所见的18例由非结核分枝杆菌感染引起的皮肤瘰疬和类皮肤瘰疬患者的临床、人口统计学和细菌学数据以及与Sweet综合征的关联。
对所有患者均获取活检标本进行组织病理学和微生物学研究。纳入从皮肤活检标本培养中分离出结核分枝杆菌和非结核分枝杆菌的患者。通过组织学切片和培养方法未发现真菌成分，排除深部真菌感染。根据致病菌种对患者使用抗菌药物或抗结核药物进行治疗。
在104例皮肤结核和非结核分枝杆菌皮肤感染患者中发现18例皮肤瘰疬（9例男性，9例女性；平均年龄36.9岁）。18例中有16例以淋巴结炎作为皮肤瘰疬的潜在病灶：15例发生在颈部组，1例发生在腹股沟区。1例从软组织引流，1例从鼻旁窦引流。5例在治疗过程中多次出现Sweet综合征。该组大多数病例（5例中的4例）为患有颈部淋巴结炎的中年女性，最常见的菌种为快速生长菌。
年龄、性别和感染部位可能对非结核分枝杆菌感染中与Sweet综合征的关联有一定影响。
