结核菌素皮肤试验高估了成年银屑病患者的结核超敏反应。

Tuberculin skin test overestimates tuberculosis hypersensitivity in adult patients with psoriasis.

作者信息

Tsiouri G, Gaitanis G, Kiorpelidou D, Dionysiou A, Efthymiou A, Daskalopoulos G, Constantopoulos S, Bassukas I D

机构信息

Department of Skin and Venereal Diseases, University of Ioannina Medical School, University Hospital of Ioannina, Ioannina, Greece.

出版信息

Dermatology. 2009;219(2):119-25. doi: 10.1159/000222431. Epub 2009 May 28.

DOI:10.1159/000222431

PMID:19478478

Abstract

BACKGROUND

Tuberculin skin testing (TST) is still the reference method for the diagnosis of latent tuberculosis infection (LTBI).

OBJECTIVE

To evaluate the effect of psoriasis on TST.

METHODS

Comparison of TST results of consecutive dermatology (n = 91) and internal medicine (n = 615) inpatients. TST was uniformly ordered, performed and evaluated according to the Mantoux method using purified protein derivative.

RESULTS

(a) Significantly larger TST indurations were measured in dermatology (median: 7 mm) compared to internal medicine inpatients (median: <1 mm; p < 0.0001). More dermatology inpatients showed 'positive' (>5 mm) and 'strongly positive' (>or=15 mm) TST results (53 vs. 29% and 22 vs. 13%, respectively). (b) Among dermatology inpatients, the TST reactions were significantly larger (p < 0.01) in psoriatics (n = 28) compared to the remaining patients (n = 63). (c) In psoriatics, the TST correlated positively with the psoriasis area and severity index score (p = 0.015).

CONCLUSION

Overt psoriasis is associated with increased TST measurements. This observation is suggestive of a possible overtreatment of these patients for LTBI.

摘要

背景

结核菌素皮肤试验（TST）仍是诊断潜伏性结核感染（LTBI）的参考方法。

目的

评估银屑病对TST的影响。

方法

比较连续的皮肤科住院患者（n = 91）和内科住院患者（n = 615）的TST结果。TST按照统一要求，采用结核菌素纯蛋白衍生物，根据芒图法进行操作和评估。

结果

（a）皮肤科住院患者的TST硬结明显大于内科住院患者（中位数：分别为7 mm和<1 mm；p < 0.0001）。更多的皮肤科住院患者TST结果呈“阳性”（>5 mm）和“强阳性”（≥15 mm）（分别为53%对29%和22%对13%）。（b）在皮肤科住院患者中，银屑病患者（n = 28）的TST反应明显大于其余患者（n = 63）（p < 0.01）。（c）在银屑病患者中，TST与银屑病面积和严重程度指数评分呈正相关（p = 0.015）。