Khanna Deepshikha, Chakravarty Payal, Agarwal Anil, Gupta Ruchika
Departments of DermatologyOrthopaedicsPathology, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.
Pediatr Dermatol. 2013 Nov-Dec;30(6):e172-6. doi: 10.1111/j.1525-1470.2012.01843.x. Epub 2012 Sep 20.
Scrofuloderma is a type of secondary tuberculosis (TB) arising from contiguous involvement of skin by an underlying tuberculous focus in the lymph nodes or bones. It may occasionally be the presenting feature of osteoarticular TB. Tuberculous dactylitis is the involvement of the small tubular bones of the hands and feet, and most cases occur in children younger than 6 years of age. Fingers are more commonly involved than toes, and painless swelling of a digit is the usual presentation. Involvement of the toes is rare, with only a few reported cases. The indolent clinical course leads to a delay in diagnosis, and bone shortening with joint deformity is the usual outcome, especially in tuberculous dactylitis affecting the foot. We report here a case of tuberculous dactylitis of the great toe and scrofuloderma affecting the nail fold presenting as painless paronychia with pseudopterygium and nail dystrophy. Nail involvement led to an early presentation and timely diagnosis and treatment before progression to permanent bone or joint deformity.
瘰疬性皮肤结核是一种继发性结核病，由淋巴结或骨骼中潜在的结核病灶累及皮肤所致。它偶尔可能是骨关节结核的首发表现。结核性指（趾）炎是手足小管状骨受累，多数病例发生在6岁以下儿童。手指比脚趾更常受累，手指无痛性肿胀是常见表现。脚趾受累罕见，仅有少数病例报道。这种隐匿的临床病程导致诊断延迟，通常会出现骨缩短和关节畸形，尤其是在累及足部的结核性指（趾）炎中。我们在此报告一例拇趾结核性指（趾）炎和累及甲襞的瘰疬性皮肤结核，表现为无痛性甲沟炎伴假性翼状胬肉和甲营养不良。指甲受累导致早期就诊，并在进展为永久性骨或关节畸形之前得到及时诊断和治疗。
