Umapathy K C, Begum R, Ravichandran G, Rahman F, Paramasivan C N, Ramanathan V D
Department of Clinic, Tuberculosis Research Centre, Chetpet, Chennai, India.
Trop Med Int Health. 2006 Oct;11(10):1521-8. doi: 10.1111/j.1365-3156.2006.01705.x.
To define the bacteriological and histological correlates of the three predominant clinical forms of cutaneous tuberculosis and to evaluate the efficacy of a 9-month daily regimen containing rifampicin and isoniazid.
In the dermatological clinics of two major teaching hospitals in Chennai, 213 patients with suspected clinical manifestations of cutaneous tuberculosis underwent examination and a skin biopsy for bacteriological and histological tests. They were treated with a daily regimen of rifampicin and isoniazid for 9 months and follow-up for 3 years.
Bacteriological and/or histological confirmation of tuberculosis was obtained in 88% of the cases. Lupus vulgaris lesions were seen mainly in the extremities and verrucosa cutis occurred predominantly on the sole and foot, while the cervical and axillary regions were the commonest sites for scrofuloderma. Ninety-two per cent of the patients showed resolution of the lesions within the first 6 months of chemotherapy; 1% failed to respond to this regimen. There was no relapse in any of the cases during the follow-up period of 3 years.
Clinical findings were adequate to identify major forms of cutaneous tuberculosis as evidenced by bacteriological and histopathological examination. A daily regimen of rifampicin and isoniazid for 9 months was effective in treating cutaneous tuberculosis.
明确皮肤结核三种主要临床类型的细菌学和组织学关联,并评估含利福平与异烟肼的9个月每日用药方案的疗效。
在金奈两家主要教学医院的皮肤科门诊,213例疑似皮肤结核临床表现的患者接受了检查及皮肤活检以进行细菌学和组织学检测。他们接受了利福平与异烟肼每日用药方案治疗9个月,并随访3年。
88%的病例获得了结核的细菌学和/或组织学确诊。寻常狼疮损害主要见于四肢,疣状皮肤结核主要发生于足底和足部,而颈部和腋窝区域是瘰疬性皮肤结核最常见的部位。92%的患者在化疗的前6个月内皮损消退;1%对该方案无反应。在3年的随访期内,所有病例均无复发。
细菌学和组织病理学检查证明,临床发现足以识别皮肤结核的主要类型。利福平与异烟肼每日用药方案治疗9个月对皮肤结核有效。