Ramesh V
Department of Dermatology and STD, Safdarjang Hospital and V.M.Medical College, New Delhi, India.
Clin Exp Dermatol. 2007 Nov;32(6):680-2. doi: 10.1111/j.1365-2230.2007.02481.x. Epub 2007 Aug 22.
Three patients with sporotrichoid cutaneous tuberculosis have been described. Two were children of either sex with lesions of lupus vulgaris along the lower limb and one woman had scrofuloderma along the left arm. Culture for Mycobacteria being negative, the diagnosis was based on the clinical picture, positive tuberculin test, granulomatous dermatitis on histopathology and regression with anti-tubercular DOTS therapy. Sporotrichoid presentation of scrofuloderma appeared to simulate sporotrichosis more than sporotrichoid lupus vulgaris. As seen from other reports and the present one, children and those just past adolescence have often been affected. Since sporotrichoid pattern is known to be usually associated with the less pathogenic atypical or non-tuberculous mycobacteria, it is speculated that the good lymphatic drainage and proneness to trauma that go with the high physical activity in these age groups may rarely result in this clinical presentation of cutaneous tuberculosis.
已描述了3例皮肤孢子丝菌病样结核患者。2例为儿童，性别不限，下肢有寻常狼疮损害，1例女性左臂有皮肤瘰疬。分枝杆菌培养阴性，诊断基于临床表现、结核菌素试验阳性、组织病理学显示肉芽肿性皮炎以及抗结核直接观察短程疗法有效。皮肤瘰疬的孢子丝菌病样表现似乎比寻常狼疮的孢子丝菌病样表现更像孢子丝菌病。从其他报道和本病例来看，儿童及刚过青春期的人群常受影响。由于已知孢子丝菌病样模式通常与致病性较低的非典型或非结核分枝杆菌有关，据推测，这些年龄组高体力活动所伴随的良好淋巴引流和易受外伤情况可能很少导致皮肤结核的这种临床表现。
