Owczarek Witold, Targowski Tomasz, Kozera-Zywczyk Anna, Paluchowska Elwira, Patera Janusz
Wojskowy Instytut Medyczny w Warszawie, Klinika Dermatologii.
Pol Merkur Lekarski. 2009 Oct;27(160):326-30.
Tuberculosis is a contagious disease induced by Mycobacterium species, acid-fast bacilli. These are mostly human type--Mycobacterium tuberculosis, less often cattle type--mycobacterium bovis or other: mycobacterium avium, kansasii, marinom, scrofulaceum, heamophilium, gordonae. The infection can affect all organs, but pulmonary tuberculosis is the most common form. The importance of tuberculosis is definitely rising in the context of massive population migrations in regions affected by its higher incidence, increased HIV infections and AIDS development. Cutaneous tuberculosis is a particular tuberculosis form with differentiated clinical picture. Non-typicalness of skin changes and oligobacilleous course of extrapulmonary tuberculosis forms are repeatedly causing difficulties in adequate diagnosis and early treatment. In differential diagnostics of cutaneous tuberculosis one must take leishmaniasis, actinomycosis, leprosy, syphilis and deep mycosis (among others) into consideration. The study is presenting a case of lupus vulgaris as a complication of past pulmonary tuberculosis. In bacteriological diagnostics of skin changes bioptates, no tuberculosis mycobacteria were found. The disease was diagnosed based on specific granulation presence in histopathology test, tuberculin hypersensivity, bacilli DNA presence in polymerase chain reaction (PCR) test and skin changes regression after anti-mycobacterium treatment. According to authors of the study, the described case confirms the usefulness of PCR nucleonic acids amplification test in cutaneous tuberculosis diagnosis.
结核病是一种由分枝杆菌属（抗酸杆菌）引起的传染病。这些细菌大多为人类型——结核分枝杆菌，较少为牛型——牛分枝杆菌或其他类型：鸟分枝杆菌、堪萨斯分枝杆菌、海分枝杆菌、瘰疬分枝杆菌、嗜血分枝杆菌、戈登分枝杆菌。感染可累及所有器官，但肺结核是最常见的形式。在结核病发病率较高的地区，大规模人口迁移、艾滋病毒感染增加和艾滋病发展的背景下，结核病的重要性无疑在上升。皮肤结核是一种临床表现各异的特殊结核形式。皮肤病变的不典型性和肺外结核形式的少菌型病程反复给准确诊断和早期治疗带来困难。在皮肤结核的鉴别诊断中，必须考虑利什曼病、放线菌病、麻风病、梅毒和深部真菌病（等等）。该研究报告了一例寻常狼疮作为既往肺结核并发症的病例。在对皮肤病变进行细菌学诊断时，活检标本中未发现结核分枝杆菌。该疾病是根据组织病理学检查中特定肉芽组织的存在、结核菌素超敏反应、聚合酶链反应（PCR）检测中杆菌DNA的存在以及抗分枝杆菌治疗后皮肤病变的消退来诊断的。根据该研究的作者，所描述的病例证实了PCR核酸扩增试验在皮肤结核诊断中的有用性。
