Kim Jin Ki, Kim Tae Yoon, Kim Dong Hyun, Yoon Moon Soo
Department of Dermatology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Ann Dermatol. 2010 Aug;22(3):341-5. doi: 10.5021/ad.2010.22.3.341. Epub 2010 Aug 5.
Primary inoculation tuberculosis results from the direct inoculation of Mycobacterium tuberculosis into the skin of a person who has no natural or artificially acquired immunity to the organism. The pathogenesis requires a break in the skin from an abrasion or injury that allows entry of the tubercle bacilli. We report 3 cases of primary inoculation tuberculosis resulting from illegal acupuncture. Three patients over 70 years old presented with erythematous, ulcerative, indurated plaques on the back. Skin lesions had developed at the acupuncture sites 1 or 2 weeks after a session of acupuncture, which was intended to relieve back pain. An unlicensed, non-medically trained person conducted each session. The patients' past medical and family histories were unremarkable. Granulomatous inflammatory infiltration and acid-fast bacilli were observed histologically. M. tuberculosis was identified by mycobacterial culture and polymerase chain reaction. Nine months after the initiation of antituberculosis medication, skin lesions improved, and no evidence of recurrence or other organ involvement was observed at the 1-year follow-up visit.
原发性接种性结核病是由于结核分枝杆菌直接接种到对该病原体无天然或人工获得性免疫力的人的皮肤中所致。其发病机制需要皮肤因擦伤或损伤而出现破损，从而使结核杆菌得以进入。我们报告了3例因非法针灸导致的原发性接种性结核病病例。3名70多岁的患者背部出现红斑、溃疡性、硬结性斑块。在旨在缓解背痛的一次针灸治疗后1或2周，针灸部位出现了皮肤病变。每次治疗均由未经许可、未接受医学培训的人员进行。患者的既往病史和家族史均无异常。组织学检查观察到肉芽肿性炎性浸润和抗酸杆菌。通过分枝杆菌培养和聚合酶链反应鉴定出结核分枝杆菌。抗结核药物治疗开始9个月后，皮肤病变有所改善，在1年的随访中未观察到复发或其他器官受累的迹象。
