Philips Rebecca C, Hunter-Ellul Lindsey A, Martin Julie E, Wilkerson Michael G
University of Texas Medical Branch.
Dermatol Online J. 2014 Jun 15;20(6):13030/qt6bs3q0h0.
We report an uncommon case of a cutaneous infection with Mycobacterium fortuitum arising in a new tattoo. A 29-year-old man presented with a several month history of a non-pruritic papular eruption within a tattoo; the papules developed 1-to-2 weeks after the tattoo procedure. He denied similar symptoms with previous tattoos. He had been treated unsuccessfully with cephalexin. Histopathologic examination revealed perifollicular chronic and granulomatous inflammation, consistent with chronic folliculitis. Acid-fast bacilli culture identified Mycobacterium fortuitum complex. The patient was treated with a 2-month course of oral trimethoprim-sulfamethoxazole (160mg/800mg twice daily) and ciprofloxacin (250 mg twice daily), with clinical improvement at follow up after three weeks of the antibiotic regimen. Rapidly growing mycobacteria have emerged as a cause of tattoo-associated cutaneous infection in recent years. Diagnosis and treatment can be difficult without clinical suspicion. M. fortuitum and other rapidly growing mycobacteria should be considered in the differential diagnosis of tattoo-associated dermatologic complications.
我们报告了一例罕见的因新纹身引发的偶然分枝杆菌皮肤感染病例。一名29岁男性，其纹身处出现了几个月的非瘙痒性丘疹疹；这些丘疹在纹身操作后1至2周出现。他否认之前纹身有类似症状。他曾接受头孢氨苄治疗，但未成功。组织病理学检查显示毛囊周围慢性和肉芽肿性炎症，符合慢性毛囊炎。抗酸杆菌培养鉴定为偶然分枝杆菌复合群。患者接受了为期2个月的口服甲氧苄啶 - 磺胺甲恶唑（每日两次，每次160mg/800mg）和环丙沙星（每日两次，每次250mg）治疗，抗生素治疗方案三周后随访时临床症状有所改善。近年来，快速生长的分枝杆菌已成为纹身相关皮肤感染的一个病因。若无临床怀疑，诊断和治疗可能会很困难。在纹身相关皮肤并发症的鉴别诊断中应考虑偶然分枝杆菌和其他快速生长的分枝杆菌。
