Departments of Dermatology Microbiology, Bellvitge Hospital, IDIBELL, Barcelona, Spain.
Clin Exp Dermatol. 2013 Mar;38(2):131-6. doi: 10.1111/j.1365-2230.2012.04463.x. Epub 2012 Oct 22.
There have been few studies on cutaneous tuberculosis (TB) in Europe in recent years. Objective. To retrospectively analyse the evolution of the various types of cutaneous TB over the past 30 years in an adult population in Spain.
Patients with cutaneous TB diagnosed between 1981 and 2011 at Bellvitge Hospital, Barcelona, Spain, were included in the study. Chest radiography was performed for all patients, and the presence of TB elsewhere in the body was excluded when clinically suspected.
In total, 36 patients (15 male, 21 female, mean age 53.72 years) were diagnosed with cutaneous TB. There were 22 patients with lupus vulgaris (LV), 4 with scrofuloderma, 4 with miliary TB, 3 with tuberculous abscess/ulcer, and 1 each with orificial TB, warty TB, and an iatrogenic inoculation from underlying visceral focus. Of the 36 patients, 16 (38.88%) had TB presenting simultaneously in other organs. Mycobacterial culture from skin biopsies was positive for Mycobacterium tuberculosis complex in 17 of the 32 cases tested (53.12%), whereas stains for acid-fast bacilli in skin samples were positive in only 3 of 36 patients (8.33%).
Although the number of cases of cutaneous TB diagnosed yearly in our population has declined over the past 30 years, cutaneous TB still exists in Europe, and its incidence is expected to increase, owing to the increased immigration into the continent in recent years. The most common type of cutaneous TB in our adult population was LV. It should be noted that despite being considered a benign form of TB, cutaneous TB can be accompanied by TB in internal organs, and severe complications can occur, such as the development of squamous cell carcinoma in long-lasting lesions.
近年来，欧洲鲜有关于皮肤结核（TB）的研究。目的：回顾性分析过去 30 年在西班牙成年人中各种类型皮肤结核的演变。
纳入 1981 年至 2011 年期间在西班牙巴塞罗那 Bellvitge 医院诊断为皮肤结核的患者。所有患者均行胸部 X 线检查，当临床怀疑有其他部位的 TB 时，排除该部位的 TB。
共诊断出 36 例皮肤结核患者（男 15 例，女 21 例，平均年龄 53.72 岁）。其中 22 例为寻常狼疮（LV），4 例为瘰疬性皮肤结核，4 例为粟粒性结核，3 例为结核性脓肿/溃疡，1 例为腔口性结核、疣状结核和医源性来自内脏病灶的接种。36 例患者中，16 例（38.88%）同时存在其他器官的 TB。在 32 例送检皮肤活检标本中，17 例（53.12%）培养出结核分枝杆菌复合群，而 36 例患者的皮肤样本中仅 3 例（8.33%）抗酸杆菌染色阳性。
尽管过去 30 年来我们人群中每年诊断的皮肤结核病例数量有所下降，但皮肤结核仍存在于欧洲，并且由于近年来欧洲大陆移民增加，预计其发病率将会增加。我们成人人群中最常见的皮肤结核类型是 LV。值得注意的是，尽管皮肤结核被认为是一种良性形式的 TB，但它可能伴有内部器官的 TB，并且可能会出现严重并发症，如长期存在的病变发展为鳞状细胞癌。
